Diaphragmatic Reconstruction with StratticeTM Biologic Mesh After Thoracic Oncologic Resection: A 10-Year Single-Center Retrospective Cohort Study

(1) Background: Large diaphragmatic defects following thoracic oncologic resection often require mesh reconstruction. Data regarding biologic mesh for this application remain limited. We evaluated clinical outcomes and durability of Strattice™, a non-cross-linked porcine acellular dermal matrix, for diaphragmatic reconstruction. (2) Methods: In this single-center, retrospective cohort study without a synthetic mesh comparator, we reviewed health records of 65 adults who underwent diaphragmatic reconstruction with Strattice™ mesh at a high-volume thoracic surgery center between 2014 and 2024. (3) Results: Mean hospital length of stay was 13.2 days. Atrial fibrillation was the most common post-operative complication, occurring in 44.6% of the patients. No diaphragmatic reconstruction recurrence or mesh replacement was observed during the available follow-up. (4) Conclusions: No reconstruction recurrence or mesh replacement was identified during the available follow-up, and wound infection was rare, supporting the feasibility of Strattice™ mesh for diaphragmatic reconstruction in this single-center cohort study. Strattice™ provided durable diaphragmatic reconstruction with a low observed wound infection rate and no identified reconstruction failure, supporting its feasibility for complex thoracic oncologic reconstruction.