92. Outcomes and Quality-of-life after Resorbable Synthetic Ventral Hernia Repair in Contaminated Fields: A Four-year Pit Stop

PURPOSE: Hernia repair in a contaminated field is a complex challenge for reconstructive surgeons as the ideal mesh type remains controversial. Recent literature has focused on evaluating safety and short-term outcomes when using different types of mesh in settings of contamination. However, data regarding outcomes beyond one year and the impact on quality-of-life are unknown. This study aims to evaluate the long-term surgical outcomes and patient-reported outcomes (PROs) after contaminated repair with poly-4-hydroxybutyrate (Phasix) mesh. METHODS: Patients undergoing a contaminated hernia repair with Phasix between 2015 and 2020 were identified. Patients with a ventral hernia defect and CDC wound class of II, III, or IV were included. Surgical site occurrences and hernia recurrences were recorded. Long-term patient-reported outcomes (PROs) as defined by the Abdominal Hernia-Q (AHQ) and Hernia-Related Quality-of-Life Survey (HRQLS) were assessed. RESULTS: Fifty-five patients were included with a mean age of 54.5, BMI of 34 kg/m2, and defect size of 356.9 ± 227.7 cm2. Median follow-up time was 49 months with a reoperation rate of 14.5% and hernia recurrence rate of 7.3%. Of the 55 patients, 37 completed preoperative and postoperative PROs questionnaires. When comparing preoperative to postoperative AHQ and HRQLS scores, there was significant improvement in overall PROs (2.1 vs 3.5, p < 0.001, 46.6 vs 71.4 p= 0.003), respectively. This improvement was maintained with no significant changes between postoperative scores over the course of 5 years. Patients with complications saw the same improvement in postoperative AHQ and HRQLS scores as those without complications. CONCLUSION: Our study found a low hernia recurrence and acceptable long-term reoperation rates in patients undergoing hernia repair with Phasix mesh in a contaminated setting. We demonstrate a sustained significant improvement in quality-of-life scores following hernia repair, even in patients with complications. This data yields insight into the long-term outcomes and quality-of-life improvement, providing physicians further knowledge to better counsel their patients.