Absorbable mesh is associated with a higher risk of recurrence and reoperation: a propensity score-matched comparison of mesh performance in clean and contaminated ventral hernia repairs
- 01.12.2026
- Original Article
Erschienen in:
- Verfasst von
- Sahil Patel
- Priscilla H. Chan
- Brandon Cowan
- Heather A. Prentice
- Kenneth Sucher
- Elizabeth W. Paxton
- Elliott Brill
- Robert Bell
- Rouzbeh Mostaedi
- Erschienen in
- Hernia | Ausgabe 1/2026
Abstract
Purpose
To compare long-term recurrence and reoperation outcomes in ventral hernia repairs (VHR) and abdominal wall reconstructions (AWR) using absorbable mesh (AM: synthetic and biologic) versus permanent mesh (PM) across CDC wound class 1–4.
Methods
Adult patients who underwent first-time elective VHR or AWR with mesh were identified using Kaiser Permanente’s integrated electronic health record (2010–2023). PM repairs were 1:1 propensity score-matched to AM repairs. Cumulative incidence via the Kaplan-Meier estimate and multivariable Cox regression were used to evaluate risk for hernia recurrence and reoperation for recurrence; secondary analysis evaluated outcomes by wound class 1, 2, and 3/4.
Results
Among 24,822 VHR and 1,341 AWR, AM were used in 1,330 (5.4%) VHR and 290 (21.6%) AWR. After matching, the 10-year cumulative recurrence was 33.7% for VHR with AM versus 25.3% for PM and AM was associated with a higher risk of recurrence (HR = 1.40, 95% CI = 1.19–1.64) and reoperation (HR = 1.81, 95% CI = 1.28–2.56) versus PM. In VHR subset analysis, AM associated with a higher recurrence risk in wound class 1 (HR = 1.53, 95% CI = 1.21–1.94) and wound class 3/4 (HR = 2.20, 95% CI = 1.08–4.94) and reoperation risk in wound class 1 (HR = 1.65, 95% CI = 1.01–2.70) and wound class 2 (HR = 1.76, 95% CI = 1.01–3.06). Synthetic and biologic AM each had higher recurrence versus PM; biologic AM also had higher reoperation. For AWR, no differences were observed at 6 years.
Conclusion
In this large, long-term propensity-matched cohort, AM for VHR was associated with higher recurrence and reoperation risk than PM, including in contaminated fields.
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- Titel
- Absorbable mesh is associated with a higher risk of recurrence and reoperation: a propensity score-matched comparison of mesh performance in clean and contaminated ventral hernia repairs
- Verfasst von
-
Sahil Patel
Priscilla H. Chan
Brandon Cowan
Heather A. Prentice
Kenneth Sucher
Elizabeth W. Paxton
Elliott Brill
Robert Bell
Rouzbeh Mostaedi
- Publikationsdatum
- 01.12.2026
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2026
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03505-6
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