Multi-Center Study To Examine The Use Of Flex HD® And Strattice In The Repair Of Large Abdominal Wall Hernias

Inclusion Criteria:

• 18 years of age or greater

• Have a BMI <40

• Have a hernia of at least 200 cm^2

• Have no contraindications to test material(s)

• Have a life expectancy greater than 1 year in the opinion of the Investigator

• Able to provide informed consent

• Able and willing to return for scheduled study visits over 1 year post-operatively (following research related surgery)

Exclusion Criteria:

• < 18 years of age

• Subject is determined to have an America Society of Anesthesiologists' (ASA) physicalclass of 4, 5, or 6.

• Have a BMI > 40

• Have a hernia < 2002 cm

• Have abdominal loss of domain such that the operation would be impractical or wouldadversely affect respiratory or cardiovascular function to an unacceptable degree inthe opinion of the Investigator

• Inability to close the fascia primarily without abdominal wall mobilization orcomponent separation

• Participation in an investigational drug or device study within the past 6 weeks priorto enrollment into this trial

• Have active necrotizing fasciitis or any other known active local or systemicinfection

• Have a known collagen metabolism disorder or any medical condition that couldinterfere with normal tissue healing process as determined by the Investigator

• Have a known active malignancy present and/or had chemotherapy 12 weeks prior toscreening or planned chemotherapy within 12 weeks of enrollment with the exception ofBCC or SCC

• Have known moderate to severe cirrhosis which in the opinion of the Investigator wouldimpact the outcome of this trial

• Have a life expectancy less than 1 year.

• Be unable to participate in the informed consent process

• Be unable or unwilling to return for scheduled study visits over the 1 yearpost-operative assessment period

• Subject's ventral hernia is related to an organ transplant surgery

• Received high dose steroids (≥100mg of prednisone) within the past 6 weeks

• Tobacco use within the past 6 weeks or positive serum cotinine test at time ofadmission

• Uncontrolled diabetes (i.e. known HbA1C value > 7%)

• History of drug addiction (recreational drugs, prescription drugs or alcohol) that inthe Investigator's opinion may interfere with protocol assessments and/or thesubject's ability to complete the required follow up

• Pregnancy and/or breastfeeding

• Enterocutaneous fistula

• Undergoing concomitant panniculectomy

• Ventral hernia repairs involving actively infected mesh removal

• Inability to obtain primary fascial closure (Intra-operatively)