Bio-resorbable poly-4-hydroxybutyrate (P4HB) mesh for abdominal wall reconstruction is effective in high-risk patients and contaminated abdomen
- 01.12.2026
- Original Article
Erschienen in:
- Verfasst von
- Anil K. Srivastava
- Katherine A. Kummer
- Bryan R. Troop
- Alison J. Gildehaus
- Kulsoom Gunn
- Gina Davis
- Erschienen in
- Hernia | Ausgabe 1/2026
Abstract
Purpose
Abdominal wall reconstruction in patients with high-risk comorbidities and contamination is controversial. There is no standardized mesh choice for such clinical circumstances. We reviewed our experience of poly-4-hydroxybutyrate (P4HB) mesh for abdominal wall reconstruction in hostile abdomen after emergency and elective abdominal surgeries.
Methods
We performed a retrospective review of 48 patients with CDC class 3 or 4 contamination and high-risk comorbidities who underwent abdominal wall reconstruction with P4HB between June 2016—October 2019. Data collected included demographics, abdominal closure techniques, and long-term surgical site complications and hernia recurrence.
Results
Patients ranged from 33–88 years old; 70% were female. BMI ranged from 14–70 kg/m2 (mean 36, SD ± 11.31). High-risk comorbidities were present in 75% of patients. Emergency abdominal closures were performed in 69% of patients. Underlay Phasix™ ST mesh was used in 71% of emergency and 53% of elective abdominal closures. Myofascial release was required in 21% of elective and 9% of emergency patients. Fascial negative pressure wound therapy was used in 45% of emergency and 20% of elective patients. Surgical site occurrences were seen in 42% of emergency and 53% of elective abdominal closures. At a mean follow-up of 41.8 months, hernias had recurred in 16% patients after emergency and 20% after elective procedures.
Conclusion
P4HB mesh is well tolerated and provides durable abdominal wall reconstruction with acceptable hernia recurrence after emergency and elective abdominal closure, making it a sensible option for abdominal closure in high-risk comorbidities and abdominal contamination.
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- Titel
- Bio-resorbable poly-4-hydroxybutyrate (P4HB) mesh for abdominal wall reconstruction is effective in high-risk patients and contaminated abdomen
- Verfasst von
-
Anil K. Srivastava
Katherine A. Kummer
Bryan R. Troop
Alison J. Gildehaus
Kulsoom Gunn
Gina Davis
- 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/s10029-025-03497-3
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