Comparing Short-Term Outcomes of Ventral Hernia Repair Using Heavyweight Non-Woven Polypropylene Mesh With Heavyweight Knitted Polypropylene Mesh.

Introduction: The mesh choice for the majority of our retromuscular repairs is heavyweight knitted polypropylene (KP) mesh. However, supply chain issues necessitated a change to a newer non-woven polypropylene mesh (NWP). We aimed to evaluate our initial experience with using NWP mesh in retromuscular abdominal wall reconstruction.

Methods: We performed a retrospective review of all patients at our institution who underwent elective, open incisional hernia repair with NWP or KP mesh from January 2014 until December 2023. The analyzed variables included patient demographics, comorbidities, operative techniques, mesh type, position, and postoperative outcomes. A propensity score model and matching algorithms were implemented to address potential treatment-choice bias. Patients receiving NWP mesh were matched with patients receiving KP mesh in a 1:2 ratio.

Results: A total of 771 patients were included in the study, 63 (8.2%) patients had their hernia repaired with NWP and 708 (91.2%) patients with KP mesh. After propensity score matching, 63 patients in the NWP group and 126 in the KP were analyzed. At 30-day follow-up, there were significantly more deep SSIs in the NWP group, however, there were no differences in readmission, reoperation, hernia recurrence, and overall SSI, SSO, and SSOPI.

Conclusion: Retromuscular hernia repaired with non-woven polypropylene mesh showed no difference in readmission, reoperation, hernia recurrence, and overall SSI, SSO, and SSOPI when compared with knitted polypropylene. There were significantly more deep SSIs in the NWP group; however, in all cases, the mesh was salvaged with local wound care, and all patients made a complete recovery. In the short term, the use of NWP mesh appears to be safe, with outcomes comparable to KP mesh.