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Abstract Incidence of incisional hernias following midline laparotomy is 20–41% after 2–4 years. CAWR (complex abdominal wall reconstruction) may be needed after due to wound contamination, loss of domain, extraction of intraperitoneal mesh, emergency enterotomies or the component separation or other complication. Biosynthetic mesh reinforcement during CAWR has significantly improved outcomes through the gradual resorption process resulting in a steady decline in mechanical strength with sufficient time to remodel. Our aim was to review the experience of our team using both polypropylene (PP) mesh and biosynthetic mesh over 12 months. A total of 40 patients with CAWR were examined (21 with PP mesh and 19 with biosynthetic mesh). Age, sex, BMI, comorbidities, mVHWG class, previous recurrence, mesh location, presence of component separation, post-operative complications were collected. The short-term results showed a significant reduction of SSO (surgical site occurrence) and shorter hospitalization when biosynthetic meshes were used. The recurrence at 6 and 12 months was similar in both groups. The results of this investigation demonstrate that biosynthetic mesh repair provides strength beyond the scope of its resorption profile with positive early outcomes and similar recurrence when compared to PP mesh. Furthermore, the use of a biosynthetic mesh in the context of contamination could offer a viable alternative to a permanent mesh prosthesis.
Duţu et al. (Wed,) studied this question.