- Design
- Prospective multi-institutional registry cohort
- Population
- 31,358 adults undergoing ventral hernia repair, 2012–2023
- Primary outcome
- 30-day wound morbidity, readmission and length of stay
- Effect
- SSI after incisional repair OR 1.40 (1.17 to 1.67) for women
A registry study of 31,358 adults having ventral hernia repair in the US compared women and men over up to three years. Women presented with more incisional, recurrent and larger hernias.
Women had higher 30-day readmission (3.4% vs 2.5%), surgical site infection (2.6% vs 1.7%) and site occurrence needing intervention (3.6% vs 2.5%). After adjustment, female sex was associated with higher odds of infection after incisional repair (OR 1.40, 95% CI 1.17 to 1.67). Recurrence was similar at one year but higher in women at two years (19.3% vs 15.7%) and three years (20.9% vs 17.6%). Women started with worse pain and quality of life but improved more.
This is an association in registry data, so it cannot say whether the difference stems from sex itself, hernia complexity or factors not recorded. It is still useful for consent.
- Include sex-specific wound and recurrence figures when consenting for complex incisional repair
- Optimise modifiable wound risks — smoking, glucose control, weight — before elective repair
- Tell women they are likely to gain substantially in quality of life despite higher complication rates
- Plan follow-up beyond one year, as recurrence differences appeared later
Why it matters
Consent figures for hernia repair are usually quoted the same for everyone, and these data suggest they should not be.
Don't overread it
An observational association — it does not show that sex itself causes the difference.
The statistics, in plain English
Absolute differences are about 1 percentage point for infection and about 3 to 4 points for recurrence at two to three years. An odds ratio of 1.40 means about 40% higher odds of infection after adjustment.
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