High-energy blunt abdominal trauma can create tearing of the abdominal wall musculature causing a traumatic abdominal wall hernia (TAWH). These injuries are challenging to manage, with previous work investigating the necessity and timing of surgical intervention [1], [2], [3], [4]. The use of mesh is sometimes employed in the repair of these injuries either as a reinforcement to a primary tissue repair, or as a bridging repair when primary fascial closure is not feasible [3], [4], [5].

The utility of mesh placement, or other specific surgical techniques, has not been investigated in detail due to the relative rarity of this injury. Previous work from this Western Trauma Association (WTA) TAWH study group found that 37.5 % of patients who underwent repair of their TAWH had mesh placed, with other data demonstrating use of mesh in 12 %−82 % of cases [3]. In contradiction to elective hernia repair, mesh use has not been associated with improved rates of hernia recurrence in TAWH, which may be due to a high rate of bridging repairs and other factors such as tissue damage or systemic inflammatory states [5,6]. Few studies have examined the differences in biologic versus synthetic mesh, risk of surgical site infection (SSI), and mesh techniques such as bridging repair versus reinforcement of primary tissue repair [5], [6], [7]. Thus, most recommendations regarding TAWH mesh placement are anecdotal, based on non-traumatic hernia literature, or expert opinion in relation to tissue quality or contamination.

This study aimed to describe specifics of mesh use and the effect of mesh placement on outcomes in the repair of blunt TAWH. We hypothesized that mesh use would be associated with a higher rate of SSI, but a similar rate of hernia recurrence compared to non-mesh repair.