Surgical endoscopy · 2026
Comparison of mesh infection management following ventral hernia repair with poly-4-hydroxybutyrate, synthetic, and biologic mesh: a retrospective review.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dickerson Kelly, Akkihal Kartik S, Ittiruck Anya, Ogola Gerald O, Wang Christine, Leeds Steven G, Ward Marc A, Spak Cedric W, Aladegbami Bola
Аннотация
BACKGROUND: Mesh infections are a feared complication of ventral hernia repair. This retrospective review compares infection characteristics and management among patients with poly-4-hydroxybutyrate (Phasix) and synthetic mesh while presenting biologic cases descriptively.
METHODS: A retrospective review was conducted of patients undergoing ventral hernia repair from 2014 to 2025. Outcomes were evaluated among patients receiving Phasix, synthetic, or biologic mesh. Primary outcomes included infection rates, microbiology, antibiotic therapy, readmission, length of stay, and need for intervention. Risk factors such as wound class, immunosuppression, and prior mesh infection were assessed.
RESULTS: A total of 407 patients underwent ventral hernia repair with Phasix (n = 47), synthetic (n = 337), and biologic (n = 23) mesh. Mesh infections developed in six patients with Phasix, seven with synthetic, and two with biologic. Of the people with mesh infections, the Phasix group demonstrated higher rates of risk factors compared to the synthetic and biologic groups: pre-existing mesh infections (33% vs. 0% vs. 0%), CDC wound class ≥ 3 (83% vs. 29% vs. 0%), and immunosuppression (33% vs. 0% vs. 0%). The bacterial profile of these mesh infections includes E. coli, Proteus mirabilis, Stenotrophomonas maltophilia, and Klebsiella pneumoniae in the Phasix group, Staphylococcus, Enterococcus faecium, and Streptococcus in the synthetic group, and Staph aureus in the biologic group. Phasix infections required a mean of 36 days of antibiotic therapy versus 15 days for synthetic and 23 days for biologic mesh (p = 0.25). Readmission rates were 67, 86, and 100%, respectively (p = 0.56). Mean hospital stays were 11, 9, and 4 days (p = 0.4). No Phasix patients required mesh excision, whereas 71.4% of synthetic mesh patients and 50% of biologic mesh patients underwent mesh explantation (p = 0.04).
CONCLUSION: Infections involving poly-4-hydroxybutyrate mesh were successfully managed without mesh explantation in this series despite occurring in higher-risk patients. Because of the retrospective design, small sample size, and potential selection bias, these findings should be considered hypothesis-generating rather than evidence of superiority.
METHODS: A retrospective review was conducted of patients undergoing ventral hernia repair from 2014 to 2025. Outcomes were evaluated among patients receiving Phasix, synthetic, or biologic mesh. Primary outcomes included infection rates, microbiology, antibiotic therapy, readmission, length of stay, and need for intervention. Risk factors such as wound class, immunosuppression, and prior mesh infection were assessed.
RESULTS: A total of 407 patients underwent ventral hernia repair with Phasix (n = 47), synthetic (n = 337), and biologic (n = 23) mesh. Mesh infections developed in six patients with Phasix, seven with synthetic, and two with biologic. Of the people with mesh infections, the Phasix group demonstrated higher rates of risk factors compared to the synthetic and biologic groups: pre-existing mesh infections (33% vs. 0% vs. 0%), CDC wound class ≥ 3 (83% vs. 29% vs. 0%), and immunosuppression (33% vs. 0% vs. 0%). The bacterial profile of these mesh infections includes E. coli, Proteus mirabilis, Stenotrophomonas maltophilia, and Klebsiella pneumoniae in the Phasix group, Staphylococcus, Enterococcus faecium, and Streptococcus in the synthetic group, and Staph aureus in the biologic group. Phasix infections required a mean of 36 days of antibiotic therapy versus 15 days for synthetic and 23 days for biologic mesh (p = 0.25). Readmission rates were 67, 86, and 100%, respectively (p = 0.56). Mean hospital stays were 11, 9, and 4 days (p = 0.4). No Phasix patients required mesh excision, whereas 71.4% of synthetic mesh patients and 50% of biologic mesh patients underwent mesh explantation (p = 0.04).
CONCLUSION: Infections involving poly-4-hydroxybutyrate mesh were successfully managed without mesh explantation in this series despite occurring in higher-risk patients. Because of the retrospective design, small sample size, and potential selection bias, these findings should be considered hypothesis-generating rather than evidence of superiority.