BACKGROUND: Data are lacking to support the choice between suture, synthetic mesh, or biologic matrix in contaminated @entity4037 repair (VHR). We hypothesize that in contaminated VHR, suture repair is associated with the lowest rate of @entity281 ( @entity281 ). METHODS: A multicenter database of all open VHR performed at from 2010-2011 was reviewed. All @entity1 with follow-up of 1  mo and longer were included. The primary outcome was @entity281 as defined by the Centers for Disease Control and Prevention. The secondary outcome was @entity547 recurrence (assessed clinically or radiographically). Multivariate analysis (stepwise regression for @entity281 and Cox proportional hazard model for recurrence) was performed. RESULTS: A total of 761 VHR were reviewed for a median (range) follow-up of 15 (1-50) mo: there were 291(38%) suture, 303 (40%) low-density and/or mid-density synthetic mesh, and 167(22%) biologic matrix repair. On univariate analysis, there were differences in the three groups including ethnicity, ASA, body mass index, institution, @entity6 , primary versus incisional @entity547 , wound class, @entity547 size, prior VHR, fascial release, skin flaps, and acute repair. The unadjusted outcomes for @entity281 (15.1%; 17.8%; 21.0%; P  =  0.280) and recurrence (17.8%; 13.5%; 21.5%; P  =  0.074) were not statistically different between groups. On multivariate analysis, biologic matrix was associated with a nonsignificant reduction in both @entity281 and recurrences, whereas synthetic mesh associated with fewer recurrences compared to suture (hazard ratio  =  0.60; P  =  0.015) and nonsignificant increase in @entity281 . CONCLUSIONS: Interval estimates favored biologic matrix repair in contaminated VHR; however, these results were not statistically significant. In the absence of higher level evidence, surgeons should carefully balance risk, cost, and benefits in managing contaminated @entity4037 repair.

Suture, synthetic, or biologic in contaminated XXXX repair.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity281 :: ('MESH:D007239', 'Disease') :: ['surgical site infection', 'SSI'] @entity547 :: ('MESH:D006547', 'Disease') :: ['hernia'] @entity4037 :: ('MESH:D006555', 'Disease') :: ['ventral hernia']
@entity4037 :: (MESH:D006555,Disease) :: ['ventral hernia']
