Health-related quality of life outcomes of bioabsorbable Phasix Mesh versus permanent synthetic mesh following open ventral hernia repair: a systematic literature review and narrative synthesis

Background: A hernia occurs when an organ or tissue protrudes through a weak spot in the surrounding muscle or connective tissue. The presence of a hernia, its surgical management, and the associated postoperative complications can substantially influence patient health-related quality of life (HRQoL). Ventral hernias often require mesh repair to reduce recurrence. While permanent synthetic meshes have historically been the standard of care, they have been associated with complications such as infection and chronic pain. As a result, patients are increasingly requesting alternatives, leading to growing interest in bioabsorbable meshes such as Phasix™ Mesh. This systematic literature review uses narrative synthesis to summarize reported HRQoL outcomes following open ventral hernia repair with Phasix™ Mesh or permanent synthetic mesh. Methods: Searches were conducted across multiple databases (i.e., MEDLINE®, Embase, Cochrane Central, and Cochrane Reviews) from 2013 to August 2024 using a peer-reviewed strategy. The primary outcome of the review was HRQoL, reported using the hernia-related quality of life survey (HerQLes). Results: Seven records of six independent studies met the inclusion criteria; four on Phasix™ Mesh and three on permanent synthetic mesh. Most studies were retrospective, with follow-up durations ranging from 12 to 66 months. A narrative synthesis was performed to summarize study design, patient characteristics, and HerQLes outcomes. Both mesh types showed improvements in HerQLes scores postoperatively. At the longest follow-up, the mean HerQLes postoperative scores were 75.25 for Phasix™ Mesh studies and 75.56 for permanent synthetic mesh studies. Quality of studies were moderate to high based on the Newcastle-Ottawa scale, supporting the reliability of findings. Conclusion: This study found that postoperative HerQLes scores improved with both Phasix™ Mesh and permanent synthetic meshes following open, ventral hernia repair. Single-arm studies of Phasix™ Mesh reported improvements in HerQLes scores up to 60 months post-surgery, including complex hernia cases. Early improvements in HerQLes scores were reported in permanent synthetic mesh studies, with reduced scores observed at the longest follow-up time points. Future large-scale, rigorously designed comparative studies are needed to confirm these findings, given no direct comparative studies are available.