REINFORCED AND NON-REINFORCED BIOLOGIC MESH VERSUS NO MESH FOR DIEP FLAP DONOR SITE REINFORCEMENT: COMPARATIVE OUTCOMES IN ABDOMINAL MORBIDITY arnavcmahajan@gwu.edu

PW04-04

REINFORCED AND NON-REINFORCED BIOLOGIC MESH VERSUS NO MESH FOR DIEP FLAP DONOR SITE REINFORCEMENT: COMPARATIVE OUTCOMES IN ABDOMINAL MORBIDITY

7

United States

Oral or Poster

Donor site complications, particularly bulge and hernia, are common after deep inferior epigastric perforator (DIEP) flap reconstruction. Mesh reinforcement may reduce these risks, but comparative data between reinforced and non-reinforced biologic meshes are limited. We evaluated outcomes with no mesh (NM), SurgiMend PRS (bovine-derived, non-reinforced ADM), and Ovitex (ovine-derived, reinforced mesh).

We retrospectively reviewed 132 DIEP flap reconstructions at George Washington University Hospital (January 2020–February 2025). Patients were grouped by reinforcement: NM (n=34), Ovitex (n=53), SurgiMend (n=45). Demographics, comorbidities, and perioperative details were collected. Complications—hernia, bulge, seroma, wound breakdown, and infection—were analyzed using chi-squared tests and multivariate logistic regression adjusting for age, BMI, race, chemotherapy, and reconstruction timing.

No hernias occurred. Bulge developed in 13 patients (~10% overall; NM: 5, Ovitex: 3, SurgiMend: 5; p=0.362). Wound breakdown was most frequent (n=21; p=0.841), followed by seroma (n=15; p=0.206) and infection (n=7; p=0.756). Multivariate analysis showed no significant differences in complication rates between reinforced, non-reinforced, or NM groups. Elevated BMI predicted higher risk of seroma (OR 1.14, p=0.032), wound breakdown (OR 1.17, p=0.006), infection (OR 1.36, p=0.023), and overall complication (OR 1.15, p=0.002). Increasing age predicted wound breakdown (OR 1.07, p=0.038) and overall complication (OR 1.06, p=0.026). Black race was protective against wound breakdown (OR 0.15, p=0.007), infection (OR 0.01, p=0.015), and overall complication (OR 0.21, p=0.003).

Reinforced and non-reinforced biologic meshes did not significantly reduce donor site morbidity compared to primary closure. BMI and age were stronger predictors of complications, highlighting the need for selective reinforcement strategies.