{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:04:20Z","timestamp":1787313860224,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fully resorbable biosynthetic mesh composed of poly\u20104\u2010hydroxybutyrate (P4HB), have been designed for incisional hernia (IH) repair, including in contaminated surgical fields. While existing studies have demonstrated its safety and efficacy in the short term, comprehensive long\u2010term data, particularly after complete mesh resorption, remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter European registry analysis investigates the incidence of short\u2010 and long\u2010term complications following IH repair with Phasix (P4HB) or Phasix ST (P4HB with hydrogel barrier; BD, Warwick, RI, USA) mesh. Adult patients from registries in France, Greece, Germany, and Spain were included and stratified using the Ventral Hernia Working Group (VHWG) classification. The primary endpoint was the incidence of long\u2010term mesh\u2010related complications one to five years post\u2010implantation, after mesh resorption. Secondary endpoints included short\u2010term complications and hernia recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 790 patients underwent incisional hernia repair with P4HB mesh, with a median follow\u2010up of 38\u00a0months (IQR 36\u201348). Long\u2010term follow\u2010up beyond 24\u00a0months was available in 57% of patients. The majority of complications occur during the first 6\u00a0months. Long\u2010term mesh\u2010related morbidity remained low, with mesh infection occurring in 2% of patients and chronic pain in 3%\u20135%, even after complete mesh resorption. Rates of enterocutaneous fistula and mesh explantation were rare. Long\u2010term complication profiles varied by hernia complexity, comorbidity burden, and mesh position, with higher ASA class associated with increased risk of mesh infection and chronic pain. The overall hernia recurrence rate was 22%, with recurrence increasing after the expected resorption period and stabilizing thereafter. Higher recurrence risk was independently associated with VHWG grade III\u2013IV (HR of 2.55 and 2.49), obesity (HR 1.41), and intraperitoneal mesh placement (HR 2.72).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>P4HB mesh demonstrated a favorable long\u2010term safety profile after complete resorption, with low rates of mesh\u2010related complications, even in high\u2010risk patients. Hernia recurrence remains an important secondary outcome and is strongly influenced by patient risk factors and surgical technique. These findings support a tailored, risk\u2010stratified approach to the use of biosynthetic meshes in IH repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70331","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T03:29:27Z","timestamp":1774063767000},"page":"1195-1205","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010Term Outcomes After Slowly Resorbable P4HB Mesh Implantation: A Multicenter Analysis From European Registry"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8850-6166","authenticated-orcid":false,"given":"Rudolf","family":"van den Berg","sequence":"first","affiliation":[{"name":"Department of Surgery Erasmus University Medical Centre  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Wieser","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University of Strasbourg, Hautepierre Hospital  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"L\u00f3pez\u2010Cano","sequence":"additional","affiliation":[{"name":"Abdominal Wall Surgery Unit, Department of General Surgery Hospital Universitari Vall d'Hebron, Unviversitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Bueno\u2010Lled\u00f3","sequence":"additional","affiliation":[{"name":"Unit of Abdominal Wall Surgery, Department of Digestive Surgery Hospital Universitari I Poltecnic La Fe, Fernando Abril Martorell  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinand","family":"K\u00f6ckerling","sequence":"additional","affiliation":[{"name":"Hernia Center Vivantes Humboldt\u2010Hospital, Academic Teaching Hospital of Charit\u00e9 University Medicine  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grigorios","family":"Chatzimavroudis","sequence":"additional","affiliation":[{"name":"Complex Hernia &amp; Abdominal Wall Reconstruction Center European Interbalkan Medical Center  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constanza","family":"Gonella\u2010Pacchiotti","sequence":"additional","affiliation":[{"name":"Department of Surgery S. Anna University Hospital and University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Stabilini","sequence":"additional","affiliation":[{"name":"Department of Surgery, Policlinico San Martino IRCCS and Department of Surgical Sciences University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Ortega\u2010Deballon","sequence":"additional","affiliation":[{"name":"Department of Digestive, Thoracic and Surgical Oncology University Hospital  Dijon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Romain","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University of Strasbourg, Hautepierre Hospital  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"PRS Group (Phasix Research Study Group)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"E. B.Deerenberg L.Timmermans D. P.Hogerzeil et\u00a0al. A Systematic Review of the Surgical Treatment of Large Incisional Hernia 2015): (Electronic) 1248\u20139204."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103252\u20109"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000001601"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","unstructured":"J. S.Roth G. J.Anthone D. J.Selzer et\u00a0al. Long\u2010Term Prospective Multicenter Study of Poly\u20104\u2010Hydroxybutyrate Mesh (Phasix Mesh) for Hernia Repair in Cohort at Risk for Complication: 60\u2010Month Follow\u2010Up 2022): (Electronic) 1879.","DOI":"10.1097\/XCS.0000000000000363"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","unstructured":"J. S.Roth G. J.Anthone D. J.Selzer et\u00a0al. Prospective Multicenter Study of P4HB (Phasix) Mesh for Hernia Repair in Cohort at Risk for Complications: 3\u2010Year Follow\u2010Up.2020: (Print)).","DOI":"10.1016\/j.amsu.2020.12.002"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.103156"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029\u2010022\u201002674\u2010y"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/as9.0000000000000366"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/as9.0000000000000032"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010010\u20101432\u20100"},{"key":"e_1_2_12_12_1","first-page":"1248","article-title":"Incisional Hernia Repair With a Slowly Absorbable P4HB Mesh: What Happens After the Mesh Disappears?","author":"Layer T.","year":"2023","journal-title":"A retrospective longitudinal clinical study"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102024\u2010098099"},{"key":"e_1_2_12_14_1","unstructured":"V. H. W.Group K.Breuing C. E.Butler et\u00a0al. Incisional Ventral Hernias: Review of the Literature and Recommendations Regarding the Grading and Technique of Repair: (Electronic)) 1532\u20137361."},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0b013e3181b13ca2"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029\u2010018\u20101813\u20101"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/prs.0000000000009021"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327752jpa6403_6"},{"key":"e_1_2_12_19_1","unstructured":"R. A.\u2010O.WilsonandY.Farooque Risks and Prevention of Surgical Site Infection After Hernia Mesh Repair and the Predictive Utility of ACS\u2010NSQIP: (Electronic) 1873\u20134626."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.92557"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.06.412"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000004713"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70331","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70331","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:07:55Z","timestamp":1779422875000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/wjs.70331"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70331","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]}}}