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Shifting the Goalpost in Ventral Hernia Care: 5-year Outcomes after Ventral Hernia Repair with Poly-4-hydroxybutyrate Mesh

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Abstract

Purpose

Ventral hernia repair (VHR) can be augmented with biosynthetic poly-4-hydroxybutryate mesh (P4HB). Long-term outcomes, including quality of life outcomes, after VHR with P4HB mesh are not well established. Our study sought to assess these outcomes 5 years after repair.

Methods

Patients who received VHR using P4HB by the senior author between 01/2015 and 09/2017 were retrospectively identified. Patients were prospectively interviewed for quality of life assessment using the Hernia-Related Quality-of-Life Survey (HerQLes) and Abdominal Hernia-Q (AHQ) and screened for recurrence. Those who screened positive were asked to follow up in clinic to confirm recurrence. Both 5-year quality of life and recurrence were univariately assessed with patient and operative factors.

Results

51 patients met inclusion criteria. 43 patients completed 5-year quality of life assessment (84.3% response rate). Quality of life scores at all postoperative time periods were greater than preoperative scores. Further, quality of life at 5 years is greater than that assessed 0–2 years following VHR. Most patients achieve their best quality of life in the 5-year time period. Thirty-five patients had clinical follow-up in the 5-year time period, 7 experienced recurrences (20% recurrence rate). There was no difference in 5-year quality of life assessment between those who had a recurrence and those who did not.

Conclusion

Patient quality of life following VHR with P4HB improves immediately and continues to improve 5 years following repair. There are no differences in quality of life with onset of recurrence. Quality of life should be the primary outcome of success in VHR.

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Authors and Affiliations

  1. Division of Plastic Surgery, University of Pennsylvania Health System, 3400 Civic Center Boulevard, 14th Floor South Tower, Philadelphia, PA, 19104, USA

    Ankoor A. Talwar, Nikhita J. Perry, Phoebe B. McAuliffe, Abhishek A. Desai, Sheri Thrippleton, Robyn B. Broach & John P. Fischer

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  1. Ankoor A. Talwar
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  2. Nikhita J. Perry
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  3. Phoebe B. McAuliffe
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  4. Abhishek A. Desai
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  6. Robyn B. Broach
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  7. John P. Fischer
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Contributions

Conception and design of the study: AAT, RBB. Data acquisition: AAT, NJP, PBM, ST. Data analysis: AAT, NJP, AAD. Data interpretation: AAT, RBB. Drafting of the article: AAT, NJP, PBM, AAD, RBB, JPF. Critical revisions of the manuscript: AAT, NJP, PBM, AAD, RBB, JPF.

Corresponding author

Correspondence to John P. Fischer.

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Conflict of interest

JPF is a paid consultant for BD which produces Phasix mesh. AAT, NJP, PBM, AAD, ST, and RBB all declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board at the Unviersity of Pennsylvania.

Informed consent

Informed consent was obtained for patient participation in the study.

Human and animal rights

No animals were affected in association with this study.

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Talwar, A.A., Perry, N.J., McAuliffe, P.B. et al. Shifting the Goalpost in Ventral Hernia Care: 5-year Outcomes after Ventral Hernia Repair with Poly-4-hydroxybutyrate Mesh. Hernia 26, 1635–1643 (2022). https://doi.org/10.1007/s10029-022-02674-y

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