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Abstract Aim The aim of this retrospective review is to analyze long term results with Poly 4 hidroxibutirate (P4HB) mesh in our institution. The main end point was recidive and its factors asociated. Material and Methods During the period between May 2015 and December 2021, 93 patients with abdominal wall complex defects were operated on, using P4HB mesh at our third-level institution in Spain. Several variables were analyzed to identify any factors related to recurrence. Multivariate statistical analysis was employed to identify independent factors. Results Out of the total cases, 26 were excluded due to insufficient follow-up time. The majority of patients were women (54%) with a mean age of 65. Midline incisional hernias were predominant (80.2%), and 80.6% were elective procedures. The most frequently used surgical technique was supra-aponeurotic repair (84.78%). Postoperative wound infection was 12.9%, and the hernia recurrence rate was 11.94%. Significant independent risk factors for recurrence included concurrent malignant neoplasm, para-stomal hernia, and postoperative complications. Conclusions P4HB is a long-term absorbable biosynthetic material. One of the possible adverse effects is a higher recurrence incidence. In our study, we observed an 11% recurrence rate, which is similar to when we use other materials. In particular, concurrent malignancy, para-stomal hernia, and postoperative complications emerged as statistically significant factors contributing to recurrence. As a result, we might say that P4HB meshes would be a useful tool in these situations in which leaving a permanent mesh could be a problem because of the high risks of complications related to them.
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