Incisional Hernia Recurrence following “Vest‐Over‐Pants” or Vertical Mayo Repair of Primary Hernias of the Midline

A series of 68 primary midline incisional hernias with a vertical Mayo repair was evaluated retrospectively. Patients without documented hernia recurrence following this repair were invited for physical examination. Life‐table methods were used for statistical analysis. The 1‐, 3‐, 5‐, and 10‐year cumulative recurrence rates were 35%, 46%, 48%, and 54%, respectively. Also, generally accepted risk factors were studied. Multivariate analysis identified the size of the hernia (p= 0.02) and the use of steroids (p= 0.04) as the most important independent risk factors of first time recurrent incisional hernia. Considering the high recurrence rates found, the results of this study strongly suggest that the vest‐over‐pants repair should no longer be used for closure of midline incisional hernias.