ArticleJournal of abdominal wall surgery : JAWS2026
Selective use of reinforced tissue matrix in complex abdominal wall reconstruction: a multicenter consensus analysis.
Article in Journal of abdominal wall surgery : JAWS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background: Optimal mesh selection in complex abdominal wall reconstruction remains controversial, particularly in contaminated fields or in patients with extensive tissue loss. Reinforced tissue matrix (RTM) meshes combine biologic material with permanent synthetic reinforcement and may represent a potential option in selected cases. This study aimed to analyze clinical use patterns of RTM meshes and identify potential indication niches through structured expert consensus. Methods: A multicenter expert panel collected cases of abdominal wall reconstruction using RTM mesh (OviTex). Patient characteristics, hernia features, operative strategies, and postoperative outcomes were recorded in a standardized database. Cases were evaluated according to established complexity criteria. Seven abdominal wall surgeons independently rated the appropriateness of RTM use. Consensus was defined as ≥70% agreement, and interrater reliability was assessed using Fleiss' kappa. Results: Seventy-four patients were included (mean age 63.9 ± 12.0 years; median BMI 30.2 kg/m Conclusion: Routine use of RTM meshes in abdominal wall reconstruction is not supported. However, RTM may represent a potential option in selected high-complexity scenarios involving contamination and large fascial defects where permanent synthetic meshes may be unsuitable. These findings are exploratory and hypothesis-generating and may support future Delphi-based indication consensus development.
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