OBJECTIVES:

There is no standard treatment for complex hernias or abdominal wall defects. In the United States, biologic grafts (xenograft tissue) are used to provide early reinforcement and remodel over time and rarely need to be removed for a post-operative infection. The challenge with biologic graft is the cost. They range from $300 - $30,000 depending on size. In recent years Phasix™ Mesh, a fully absorbable synthetic mesh, was introduced into the market to address some limitations associated with biologic mesh. Phasix™ Mesh handles like synthetic mesh, retains it’s strength throughout the critical initial healing phase and remodels over time. The purpose of the study is to compare the clinical and cost-effectiveness of Phasix™ mesh vs the Strattice™ Tissue Matrix in the inpatient hospital surgical setting.

METHODS:

A retrospective analysis of inpatient hospital procedures using either Phasix or Strattice for treatment of Ventral Hernia from the Premier Hospital Database was conducted. Rates of post-operative infection, reported as a count and percent of discharges in Adult patients (>18) with a procedure between Q3 2013 to Q4 2016 were evaluated. Total costs for the procedure, re-operations and clinical complications were collected.

RESULTS:

The analysis produced cohorts of 1,020 for Strattice and 818 for Phasix. Average Length of Hospital Stay (LOS) for Strattice was 11.8 days, SD 18.2 and for Phasix was 7.9 days, SD 12.9. Average Cost of procedure with Phasix was associated with a lower all-cause cost of $9,683 (Strattice: $41,086, SD $80,010 vs Phasix: $31,403, SD $48,392).

CONCLUSIONS:

Ventral and Incisional hernia repair in patients with underlying comorbid conditions, can result in frequent complications. Lower healthcare utilization and inpatient hospital cost was found to be associated with the use of Phasix compared to Strattice. The research shows that Phasix can be more cost-effective than biologic grafts, such as Strattice.