Trends in Mesh Materials for Ventral Hernia Repair: A 17-Year Nationwide Registry-Based Study

Abstract

Background

Mesh reinforcement is recommended for ventral hernia repair and can include various materials in different combinations. This study analyzed the mesh materials used and their temporal trends in ventral hernia repair in Denmark over the past 17 years.

Methods

This study utilized prospectively collected data from the Danish Ventral Hernia Database, maintained from its inception in 2007 to 2023. The data were cleaned and organized by mesh material. All ventral hernia repairs with mesh were included.

Results

A total of 47,716 operations were included, utilizing many different mesh materials. Polypropylene meshes were used in 62% of the repairs, polyester in 26%, and fully absorbable meshes in 0.7%. Per- and polyfluoroalkyl substances (PFAS)-based meshes were most commonly used from 2007 to 2011 but then experienced a marked decline, followed by a slight increase in 2023. While the use of other absorbable components in semi-absorbable meshes followed a rise-and-fall pattern during the study period, only polylactic acid (PLA) showed a steady increase from 2013 onward.

Conclusion

A wide range of mesh materials and composites have been utilized for ventral hernia repair from 2007 to 2023. Polypropylene-based meshes were most commonly used, followed by polyester. The use of various absorbable composite materials varied considerably over time. The diversity of mesh materials and substantial temporal variations highlight gaps in evidence-based clinical practice and the need for improved regulations. These findings emphasize the importance of developing standardized guidelines for mesh selection in ventral hernia repair.