Biologic mesh is non-inferior to synthetic mesh in CDC class
Biologic and synthetic mesh were compared in patients with CDC Class 1&2 wounds. The biologic mesh was more likely to be used in immunocompromised patients. Hernia recurrence was similar between the biologic (1.7%) and synthetic (3.4%) groups. Postoperative complications were comparable between mesh types.

A prospective abdominal wall reconstructions (AWRs) database identified patients undergoing open, preperitoneal AWR with biologic mesh in CDC class 1 and 2 wounds. Using propensity score matching, a matched cohort of patients with synthetic mesh was created. The objective was to assess recurrence rates and postoperative complications. Fifty-eight patients were matched in each group.

- Patients in the biologic group had higher rates of immunosuppression, history of transplantation, and inflammatory bowel disease.

- Operative variables were comparable for biologic vs synthetic, including defect size, but the synthetic mesh group had larger meshes placed.

- Wound infections were equivalent, and recurrence rates were similar on follow-up.

Conclusively, in matched, lower risk, complex AWR patients with large hernia defects, biologic and synthetic meshes have equal outcomes.