Prevention of Incisional Hernias with Biological MeshA Systematic Review of the Literature
Background: Prophylactic mesh augmented reinforcement during closure of abdominal wall incisions has been proposed in patients with increased risk for development of incisional hernias (IH). As part of the BioMesh consensus project, a systematic literature review has been performed to detect those s...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-09-01
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| Series: | Frontiers in Surgery |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fsurg.2016.00053/full |
| _version_ | 1811263829190901760 |
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| author | FILIP ETIENNE MUYSOMS An Jairam Manuel López-Cano Maciej Śmietański Maciej Śmietański Guido Woeste Iris Kyle-Leinhase Stavros Athanasios Antoniou Stavros Athanasios Antoniou Ferdinand Köckerling |
| author_facet | FILIP ETIENNE MUYSOMS An Jairam Manuel López-Cano Maciej Śmietański Maciej Śmietański Guido Woeste Iris Kyle-Leinhase Stavros Athanasios Antoniou Stavros Athanasios Antoniou Ferdinand Köckerling |
| author_sort | FILIP ETIENNE MUYSOMS |
| collection | DOAJ |
| description | Background: Prophylactic mesh augmented reinforcement during closure of abdominal wall incisions has been proposed in patients with increased risk for development of incisional hernias (IH). As part of the BioMesh consensus project, a systematic literature review has been performed to detect those studies where MAR was performed with a non-permanent absorbable mesh (biological or biosynthetic). Methods: A computerized search was performed within 12 databases (Embase, Medline, Web-of-Science, Scopus, Cochrane, CINAHL, Pubmed publisher, Lilacs, Scielo, ScienceDirect, ProQuest, Google scholar) with appropriate search terms. Qualitative evaluation was performed using the MINORS score for cohort studies and the Jadad score for RCTs. Results: For midline laparotomy incisions and stoma reversal wounds, 2 RCTs, 2 case control studies and 2 case series were identified. The studies were very heterogeneous in terms of mesh configuration (cross linked versus non cross linked), mesh position (intraperitoneal versus retromuscular versus onlay), surgical indication (gastric bypass versus aortic aneurysm), outcome results (effective versus non effective). After qualitative assessment we have to conclude that the level of evidence on the efficacy and safety of biological meshes for prevention of incisional hernias is very low. No comparative studies were found comparing biological mesh with synthetic non-absorbable meshes for the prevention of incisional hernias. Conclusion: There is no evidence supporting the use of non-permanent absorbable mesh (biological or biosynthetic) for prevention of incisional hernias when closing a laparotomy in high-risk patients or in stoma reversal wounds. There is no evidence that a non-permanent absorbable mesh should be preferred to synthetic non-absorbable mesh both in clean or clean-contaminated surgery. |
| first_indexed | 2024-04-12T19:53:30Z |
| format | Article |
| id | doaj.art-8cf91716a1234a2fb2bff2e3f2a56eb1 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-12T19:53:30Z |
| publishDate | 2016-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-8cf91716a1234a2fb2bff2e3f2a56eb12022-12-22T03:18:46ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2016-09-01310.3389/fsurg.2016.00053222898Prevention of Incisional Hernias with Biological MeshA Systematic Review of the LiteratureFILIP ETIENNE MUYSOMS0An Jairam1Manuel López-Cano2Maciej Śmietański3Maciej Śmietański4Guido Woeste5Iris Kyle-Leinhase6Stavros Athanasios Antoniou7Stavros Athanasios Antoniou8Ferdinand Köckerling9Maria MiddelaresErasmus University Medical CenterVall'd Hebron Hospital, Universidad Autónoma de BarcelonaDistrict Hospital in PuckMedical University of GdanskKlinikum der Johann Wolfgang Goethe-UniversitätMaria MiddelaresHospital NeuwerkUniversity of Heraklion, CreteVivantes HospitalBackground: Prophylactic mesh augmented reinforcement during closure of abdominal wall incisions has been proposed in patients with increased risk for development of incisional hernias (IH). As part of the BioMesh consensus project, a systematic literature review has been performed to detect those studies where MAR was performed with a non-permanent absorbable mesh (biological or biosynthetic). Methods: A computerized search was performed within 12 databases (Embase, Medline, Web-of-Science, Scopus, Cochrane, CINAHL, Pubmed publisher, Lilacs, Scielo, ScienceDirect, ProQuest, Google scholar) with appropriate search terms. Qualitative evaluation was performed using the MINORS score for cohort studies and the Jadad score for RCTs. Results: For midline laparotomy incisions and stoma reversal wounds, 2 RCTs, 2 case control studies and 2 case series were identified. The studies were very heterogeneous in terms of mesh configuration (cross linked versus non cross linked), mesh position (intraperitoneal versus retromuscular versus onlay), surgical indication (gastric bypass versus aortic aneurysm), outcome results (effective versus non effective). After qualitative assessment we have to conclude that the level of evidence on the efficacy and safety of biological meshes for prevention of incisional hernias is very low. No comparative studies were found comparing biological mesh with synthetic non-absorbable meshes for the prevention of incisional hernias. Conclusion: There is no evidence supporting the use of non-permanent absorbable mesh (biological or biosynthetic) for prevention of incisional hernias when closing a laparotomy in high-risk patients or in stoma reversal wounds. There is no evidence that a non-permanent absorbable mesh should be preferred to synthetic non-absorbable mesh both in clean or clean-contaminated surgery.http://journal.frontiersin.org/Journal/10.3389/fsurg.2016.00053/fullpreventionprophylaxisSystematic reviewincisional herniaBiological meshbio-absorbable mesh |
| spellingShingle | FILIP ETIENNE MUYSOMS An Jairam Manuel López-Cano Maciej Śmietański Maciej Śmietański Guido Woeste Iris Kyle-Leinhase Stavros Athanasios Antoniou Stavros Athanasios Antoniou Ferdinand Köckerling Prevention of Incisional Hernias with Biological MeshA Systematic Review of the Literature Frontiers in Surgery prevention prophylaxis Systematic review incisional hernia Biological mesh bio-absorbable mesh |
| title | Prevention of Incisional Hernias with Biological MeshA Systematic Review of the Literature |
| title_full | Prevention of Incisional Hernias with Biological MeshA Systematic Review of the Literature |
| title_fullStr | Prevention of Incisional Hernias with Biological MeshA Systematic Review of the Literature |
| title_full_unstemmed | Prevention of Incisional Hernias with Biological MeshA Systematic Review of the Literature |
| title_short | Prevention of Incisional Hernias with Biological MeshA Systematic Review of the Literature |
| title_sort | prevention of incisional hernias with biological mesha systematic review of the literature |
| topic | prevention prophylaxis Systematic review incisional hernia Biological mesh bio-absorbable mesh |
| url | http://journal.frontiersin.org/Journal/10.3389/fsurg.2016.00053/full |
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