How synthetic meshes perform in incisional hernia repair

Abstract

Mechanical biocompatibility reflects the ability of a prosthetic mesh to integrate within host tissues while maintaining appropriate mechanical behavior. This retrospective study analyzed 213 patients who underwent incisional hernia repair to assess the clinical performance of polypropylene, polyester, and composite meshes. Evaluated variables included defect size, operative duration, suture type, mesh type, and patient comorbidities. Outcomes comprised hospitalization length and postoperative complications. No statistically significant differences were found among mesh types regarding hospitalization time or complication rates, suggesting comparable clinical and mechanical biocompatibility. Polyester meshes were more frequently used for smaller defects, whereas polypropylene meshes predominated for larger defects, reflecting technical rather than clinical considerations. Age showed a moderate positive correlation with hospitalization duration. In univariate analysis, operative procedures lasting approximately 2 hours were associated with higher complication rates; however, in multivariable logistic regression, chronic pulmonary disease (COPD) emerged as the only independent predictor of postoperative complications. Mesh type, operative duration, and surgical technique were not independently associated with adverse outcomes. These findings indicate that postoperative evolution in incisional hernia repair depends primarily on patient-related factors and intraoperative mechanical conditions rather than on the intrinsic polymer composition of the mesh.