ArticleSurgical endoscopy2026
Comparison of mesh infection management following ventral hernia repair with poly-4-hydroxybutyrate, synthetic, and biologic mesh: a retrospective review.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
backgroundMesh 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.
methodsA 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.
resultsA 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
conclusionInfections 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.
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