Experts Advocate for P4HB Mesh as Safer Alternative to Polypropylene

Dr. Greg Vigna

P4HB mesh reduces infection risk and improves outcomes in contaminated fields, offering a safer alternative to polypropylene mesh

LOS ANGELES, CA, UNITED STATES, September 25, 2025 /EINPresswire.com/ -- Dr. Greg Vigna, board certified in Physical Medicine and Rehabilitation, states “During my clinical practice at a long-term acute care hospital, we frequently treated patients suffering from complications due to infected abdominal mesh. After surgical removal of infected polypropylene mesh, these patients were left with large abdominal wounds. Their treatment required long-term hospitalizations, vac packs, specialized wound care nurses, intravenous antibiotics, pain management, and nutritional support.”

Dr. Vigna adds, “Once the wound had improved and was cleared of soft tissue infection, the patient typically required surgical closure, either through abdominal wall reconstruction by a plastic surgeon without mesh or revision surgery by a general surgeon using a new polypropylene mesh. Today, these types of complications can be significantly reduced by using fully resorbable P4HB mesh."

What does Dr. David C. Chen, General Surgeon, say in "Fully resorbable poly-4-hydroxybutyrate (P4HB) mesh for soft tissue repair and reconstruction: A scoping review" published in Frontiers in Surgery 12 April 2023?

“After a thorough evaluation of the clinical studies identified by this scoping review, several major themes emerged, namely: (1) P4HB mesh provides long term strength at the repair site, leading to acceptable rates of recurrence as compared to higher-risk cohorts and those repaired with non-synthetic biomaterials; (2) P4HB mesh performs favorably in contaminated settings where permanent synthetic mesh use may be higher risk or contraindicated, resulting in low incidence of surgical site infection (SSI)

Finally, when P4HB mesh was utilized to replace infected mesh in a single-stage approach, Bueno-Lledo et al. reported a recurrence rate of 6.6% and SSI of 3.3%.

They compared these results to a second cohort in which permanent synthetic mesh was used to replace infected mesh in a two-stage approach. The permanent synthetic mesh cohort exhibited a recurrence rate comparable to that of P4HB mesh, but a three times greater incidence of surgical site infection."

Read Dr. Chen’s article: https://pubmed.ncbi.nlm.nih.gov/37123542/.

Dr. Vigna concludes, “Hernia mesh infections are serious medical complications that often lead to extended recovery times and, in some cases, multiple surgical procedures. Physicians who continue to implant polypropylene hernia mesh in infected surgical fields are subjecting their patients to avoidable risks. These complications can be greatly reduced or eliminated by using P4HB mesh.”

Complications of abdominal mesh and inguinal mesh infection include: 1) Chronic pain, 2) Mesh-enteric fistula, 3) Reoccurrence of hernia, 4) Sepsis, and 5) Septic shock. Treatments may include 1) Local debridement and VAC pack with antibiotics, 2) Partial mesh excision with antibiotics, 3) Complete mesh removal with antibiotics, and 4) abdominal wall reconstruction with or without mesh.

Dr. Vigna is a California and Washington, D.C., lawyer who focuses on serious injuries caused by defective devices. He represents the injured from defective hernia mesh and litigates these cases with the Ben Martin Law Group, a national pharmaceutical injury law firm in Dallas, Texas.

To learn more about hernia mesh, click here.

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Greg Vigna, MD, JD
Vigna Law Group
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