Purpose <p>Bioresorbable mesh is becoming increasingly common in complex cases. However, the outcomes of mesh salvage following complicated hernia repair with bioresorbable mesh have not been well-characterized. We report a series of three cases involving the salvage of poly-4-hydroxybutyrate (P4HB) bioresorbable mesh following ventral hernia repair (VHR).</p> Methods <p>We conducted a systematic review of the literature to elicit current outcomes of hernia mesh salvage in VHR using bioresorbable mesh. We then included patients who presented with postoperative complications following VHR using P4HB mesh at Tampa General Hospital (TGH).</p> Results <p>Nineteen cases of bioresorbable mesh salvage following VHR are reported in existing literature, with varying success rates. Three reported cases of mesh complication with P4HB at TGH were analyzed. The mean time to hospital presentation for postoperative complications was 37.3 days, with a median of 30 days. Complications included dehiscence (3/3 cases), infection (2/3 cases), necrosis (2/3 cases), and exposed mesh (2/3 cases). Postoperative procedures included incision and drainage (2/3 cases) and debridement (2/3 cases). Mesh salvage was successful in all cases. Complete mesh removal was not required in any case. Negative pressure wound therapy (NPWT) was utilized in all cases after wound dehiscence and complication. One patient experienced chronic diarrhea and incomplete wound closure after 12 months. There were no instances of hernia recurrence.</p> Conclusion <p>Mesh complications are inevitable in a percentage of complex hernia repairs. Salvage of P4HB mesh in complicated VHR was successful in all reported cases at our institution.</p>