Clinical ScienceProspective repair of Ventral Hernia Working Group type 3 and 4 abdominal wall defects with condensed polytetrafluoroethylene (MotifMESH) mesh

•We prospectively studied VHWG Grade 3 and 4 hernias repaired with cPTFE mesh.•For 10 patients, there were zero surgical site infections after 30 days.•At 1 year, only 1 patient had a mesh infection requiring removal.•At 1 year, 90% of patients were hernia free.•For VHWG Grade 3 and 4 patients, cPTFE provides a safe option for hernia repair.

BackgroundTreatment of clean-contaminated and contaminated ventral hernia defects remains controversial. Newer prosthetic materials may play an important role in these patients.MethodsTen patients with Ventral Hernia Working Group types 3 and 4 were prospectively enrolled and subsequently treated with direct supported repairs with condensed fenestrated polytetrafluoroethylene mesh. The primary outcome was hernia occurrence at 1 year after surgery. Secondary outcomes included surgical site infection, surgical site occurrence, medical complications, pain, and other patient-reported outcomes.ResultsThere were no immediate postoperative infections and one minor postoperative hematoma treated in the office. One patient required delayed mesh removal 9 months after placement. Importantly, the mesh removal procedure was straightforward because of the material properties of the mesh. Of the 9 patients still with mesh, there were no hernia recurrences at the repair site with one full year of follow-up.ConclusionContaminated and clean-contaminated abdominal wall defects can be effectively and durably treated with condensed polytetrafluoroethylene mesh.