Complex Ventral Hernia Repair Using Biologic or Synthetic Mesh

Inclusion Criteria: * Clinical evidence of a midline, ventral hernia, regardless of degree of wound contamination, with the exception of class IV wounds due to the presence/discovery of fecal peritonitis. Specifically, the repair will or will not involve a compromised surgical field in which gastrointestinal, biliary and/or genitourinary procedures will be performed. The surgical wound class may be classified as clean, or it may be classified as clean-contaminated, contaminated, or dirty-infected, due to the repair of an enterocutaneous fistula, takedown of an intestinal stoma and/or removal of infected mesh * Age \>21 * Negative pregnancy test * No allergic, religious or ethical objections to either polypropylene or porcine prosthetics * Signed, witnessed informed consent to take part in the study Exclusion Criteria: * Lactating women * Patients who are unable to commit to the follow evaluations over 24 months * Severe malnutrition (serum albumin \<2.0 in the setting of a normal CRP) * Use of an investigational agent within 1 month prior to study enrollment and/or planned during this study * Presence of pre-existing parenchymal liver disease characterized by the presence of Child's Class C liver dysfunction (including all of the following: bilirubin ≥ 3.0 mg/dL; albumin ≤ 3.0 mg/dL; refractory ascites; encephalopathy or coma; and poor nutritional status) * Immunocompromised patients, as evidenced by: administration of high doses of corticosteroids (i.e. doses ≥ 1.5 mg/kg/…