Prospective, multi-institutional surgical and quality-of-life outcomes comparison of heavyweight, midweight, and lightweight mesh in open ventral hernia repair

Abstract

Background Mesh choice in open ventral hernia repair (OVHR) remains controversial. Our aim was to analyze prospective outcomes among heavyweight, midweight, and lightweight (LW) mesh. Methods A study of the International Hernia Mesh Registry was performed for OVHR. Operative details, complications, recurrence, and quality of life (QOL) at 1, 6, 12, 24, and 36 months were evaluated. Results There were 549 OVHRs, 99 using heavyweight, 262 midweight, and 188 LW mesh. Heavyweight group had larger defects (P ≤ .008). Midweight patients had fewer superficial surgical site infections (P = .04) and shorter LOS (P < .0001). Recurrence rates were equal (6.1% vs 6.1% vs 8.0%; P = .71). After controlling for surgical location, component separation, and preoperative pain with multivariate analysis, LW mesh was associated with an overall worse QOL at 6 months and pain at 1 year. Conclusions MW mesh had fewer superficial surgical site infections and shorter LOS. After controlling for potential confounding variables, LW mesh had a worse QOL at 6 and 12 months.