World Journal of Surgery

, Volume 38, Issue 1, pp 40–50 | Cite as

Biologic Versus Nonbiologic Mesh in Ventral Hernia Repair: A Systematic Review and Meta-analysis

  • Ali Darehzereshki
  • Melanie Goldfarb
  • Joerg Zehetner
  • Ashkan Moazzez
  • John C. Lipham
  • Rodney J. Mason
  • Namir Katkhouda
Article

Abstract

Background

The current standard of treatment for most ventral hernias is a mesh-based repair. Little is known about the safety and efficacy of biologic versus nonbiologic grafts. A meta-analysis was performed to examine two primary outcomes: recurrence and wound complication rates.

Methods

Electronic databases and reference lists of relevant articles were systematically searched for all clinical trials and cohort studies published between January 1990 and January 2012. A total of eight retrospective studies, with 1,229 patients, were included in the final analysis.

Results

Biologic grafts had significantly fewer infectious wound complications (p < 0.00001). However, the recurrence rates of biologic and nonbiologic mesh were not different. In subgroup analysis, there was no difference in recurrence rates and wound complications between human-derived and porcine-derived biologic grafts.

Conclusions

Use of biologic mesh for ventral hernia repair results in less infectious wound complications but similar recurrence rates compared to nonbiologic mesh. This supports the application of biologic mesh for ventral hernia repair in high-risk patients or patients with a previous history of wound infection only when the significant additional cost of these materials can be justified and synthetic mesh is considered inappropriate.

Keywords

Hernia Repair Incisional Hernia Ventral Hernia Wound Complication Ventral Hernia Repair 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

CST

Component separation technique

OR

Odds ratio

CI

Confidence interval

HADM

Human acellular dermal matrix

HBM

Human biologic mesh

PBM

Porcine biologic mesh

PCL

Porcine cross-linked

PNCL

Porcine non-cross-linked

AD

AlloDerm

FHD

FlexHD

Notes

Conflict of interest

None.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Ali Darehzereshki
    • 1
  • Melanie Goldfarb
    • 1
  • Joerg Zehetner
    • 1
  • Ashkan Moazzez
    • 2
  • John C. Lipham
    • 1
  • Rodney J. Mason
    • 1
  • Namir Katkhouda
    • 1
  1. 1.Division of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of USCUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.H. Claude Hudson Comprehensive Health CenterLos AngelesUSA

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