The Effects of Onlay Titanium-coated Mesh on Recurrence, Foreign Body Feeling and Chronic Pain in Ventral Hernia

Background: There are many complications of meshes in hernia repair. The aim of this study was to investigate the effects of onlay titanium-coated meshes (TCM) on recurrence, foreign body feeling and chronic pain in ventral hernia repair. Methods: In this retrospective cohort study, patients who underwent TCM and polypropylene mesh (PM) for onlay repair of ventral hernia were examined between May 2014 and January 2018 at our centre. Patient characteristics, type of hernia, defect size, operative time, follow-up time, surgical site occurrence (infection, seroma and hematoma), recurrence, foreign body feeling and chronic pain were analysed. Patients were divided into two groups according to the mesh elected; TCM (titanium group) or PM (polypropylene group). Results: Out of 160 patients, 63 (32.6%) had TCM and 97 (67.4%) had PM. There was no significant difference between groups in terms of recurrence ( p  = 0.757). Chronic pain and foreign body feeling were low in the titanium group ( p  = 0.047 and p  = 0.029, respectively), a positive correlation was found between surgical site infection and recurrence ( p  = 0.020). In the polypropylene group, an increase in defect size was significantly associated with foreign body feeling and chronic pain ( p  < 0.001 for both comparisons). Conclusion: In onlay repair of ventral hernia, TCM led to less foreign body feeling and chronic pain then PM. The surgical site infection was associated with recurrence for these meshes. Additionally, the increase in defect size causes a risk for foreign body feeling and chronic pain in repair using PM.