The article by Arnaud et al1 demonstrates 3 important principles of successful incisional hernia repairs. The repair is tension free, the mesh used is considerably larger than the fascial defect allowing for tissue ingrowth and incorporation, and the mesh is anchored to healthy tissue. The relatively low rates of recurrence (3.2%) and infection (4%) described by the authors are to be commended. Many series using mesh repairs have described recurrence rates from 6% to 10%2,3 and infection rates around 6%.4 Other techniques using autologous tissue, such as muscle advancement procedures, tend to have higher recurrence rates, presumably owing to increased tension on the repairs. The infection rates with autologous tissue are only slightly lower than rates with mesh repairs.
Brunicardi FC. Surgical Treatment of Postoperative Incisional Hernias by Intraperitoneal Insertion of a Dacron Mesh and an Aponeurotic Graft. Arch Surg. 2000;135(2):238. doi:10.1001/archsurg.135.2.238