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



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.


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.


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.


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.


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.



Component separation technique


Odds ratio


Confidence interval


Human acellular dermal matrix


Human biologic mesh


Porcine biologic mesh


Porcine cross-linked


Porcine non-cross-linked






Conflict of interest



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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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