HERNIA RECURRENCE, CHRONIC PAIN AND INFECTION IN PATIENTS UNDERGOING OPEN REPAIR OF VENTRAL HERNIA OR DIVARICATION OF RECTUS ABDOMINUS WITH MONOFILAMENT POLY-4-HYDROXYBUTYRATE MESH: A RETROSPECTIVE, PATIENT-REPORT CASE SERIES

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Abstract Aim To report rates of patient-reported hernia recurrence, chronic pain and re-operation for surgical site infection (SSI) in patients who underwent open repair of ventral hernia or divarication of rectus abdominus using monofilament Poly-4-hydroxybutyrate (P4HB) mesh. Method Multi-centre, retrospective case series using prospectively collected anonymous patient-reported outcomes. Inclusion criteria: diagnosis of Spigelian, incisional or umbilical hernia or divarication of rectus abdominus; open repair using resorbable P4HB monofilament mesh. Primary outcome: recurrence rate using Ventral Hernia Recurrence Inventory (VHRI). Secondary outcomes: (1) chronic pain using a modified item from Ventral Hernia Pain Questionnaire (VHPQ); (2) rate of re-operation for SSI. Results Twenty-four of 42 (57%) eligible patients participated: 54% of participants were female and 75% were aged ≥50 years. On VHRI, 13% of participants reported their hernia had come back, 25% felt or saw a bulge, 46% reported physical symptoms or pain at the site. On the VHPQ modified item, 79% of participants reported either no pain or pain that can easily be ignored, the remaining 21% reporting higher levels of pain. Three participants (13%) reported having a follow-up procedure for SSI. Female participants reported higher rates of pain or symptoms at the site, levels of pain and follow-up procedures for SSI. Conclusions Recurrence rates for patients with ventral hernia or rectus abdominus who underwent open repair with P4HB mesh were broadly similar to previously published ventral hernia recurrence rates. Female participants experienced higher rates and levels of pain, and more frequent follow up procedures for SSI.

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