Risk of adverse outcomes by plug and flat mesh following 90,319 open inguinal hernia repairs
- 01.12.2025
- Original Article
Erschienen in:
- Verfasst von
- Maria M. Korah
- Priscilla H. Chan
- Heather A. Prentice
- Kenneth Sucher
- Cheryl L. Park
- Gregory M. Heitmann
- Elizabeth W. Paxton
- Rouzbeh Mostaedi
- Elliott R. Brill
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
We sought to evaluate the risks for reoperation, recurrence, and groin pain following open inguinal hernia repair with a plug versus flat mesh.
Methods
We conducted a cohort study including 90,319 patients ≥ 18 years who underwent first elective open inguinal hernia repair with polyester/polypropylene mesh within a US integrated healthcare system (1/2010–6/2023). Plug versus flat mesh were the treatment groups. Reoperation related to the index hernia repair, as well as other reoperation reasons, and recurrence during follow-up were primary outcomes, while 5-year postoperative groin pain (excluding first 6-month postoperative acute recovery period) was a secondary outcome. Multiple Cox regression was used to evaluate risk of longitudinal outcomes, while multiple logistic regression was used to evaluate groin pain, with covariate adjustment.
Results
Plugs were used in 37,490 (41.5%) repairs; plug use declined from 53.0% in 2010 to 13.9% in the first six months of 2023. No difference in risk for reoperation (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 0.92–1.16) or recurrence (HR = 0.93, 95% CI = 0.83–1.04) was found for plug compared to flat mesh. A higher risk of reoperation for device infection was observed with plug use compared to flat mesh (HR = 2.71, 95% CI = 1.09–6.77). In adjusted analysis, no difference in the likelihood of groin pain was observed (odds ratio = 1.08, 95% CI = 1.00–1.17).
Conclusion
Plug mesh for open inguinal hernia repairs were not found to have improved outcomes compared to flat mesh but a higher risk of reoperation for infection. These findings align with the current literature, which generally advises against the use of mesh plugs due to associated risks and complications.
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- Titel
- Risk of adverse outcomes by plug and flat mesh following 90,319 open inguinal hernia repairs
- Verfasst von
-
Maria M. Korah
Priscilla H. Chan
Heather A. Prentice
Kenneth Sucher
Cheryl L. Park
Gregory M. Heitmann
Elizabeth W. Paxton
Rouzbeh Mostaedi
Elliott R. Brill
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03342-7
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