![]() The routine use of biologic and biosynthetic meshes cannot be recommended. In complex abdominal wall hernia repairs (incarcerated hernia, parastomal hernia, infected mesh, open abdomen, enterocutaneous fistula, and component separation technique), biologic and biosynthetic meshes do not provide a superior alternative to synthetic meshes. For prevention of incisional or parastomal hernias, there is no evidence to support the use of biologic/ biosynthetic meshes. In inguinal hernia repair biologic and biosynthetic meshes do not have a clear advantage over the synthetic meshes. ![]() Biologic mesh use should be avoided when bridging is needed. The cumulative data regarding biologic mesh under contaminated conditions do not support the claim that it is better than synthetic mesh. For the review, 114 studies and background analyses were used. Findings were set out in writing by the subgroups followed by consensus being reached. In January 2016, a workshop was held in Berlin where the findings were presented, discussed, and voted on for consensus. A European working group, "Bio Mesh Study Group", composed of invited surgeons with a special interest in surgical meshes, formulated key questions, and forwarded them for processing in subgroups. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations. ![]() Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. Köckerling, F Alam, N N Antoniou, S A Daniels, I R Famiglietti, F Fortelny, R H Heiss, M M Kallinowski, F Kyle-Leinhase, I Mayer, F Miserez, M Montgomery, A Morales-Conde, S Muysoms, F Narang, S K Petter-Puchner, A Reinpold, W Scheuerlein, H Smietanski, M Stechemesser, B Strey, C Woeste, G Smart, N JĪlthough many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction? Copyright © 2017 American College of Surgeons. Additional post-market analysis is needed to provide evidence defining best mesh choices, location, and surgical technique for repairing contaminated ventral hernias. Biosynthetic mesh appears to have higher rates of 30-day wound morbidity compared with polypropylene mesh in elective OVHR with clean-contaminated or contaminated wounds. ![]() However, surgical site infections (22.4% vs 10.9% p = 0.03), surgical site occurrences requiring procedural intervention (24.1% vs 13.2% p = 0.049), and reoperation rates (13.8% vs 4.0% p = 0.009) were significantly higher in the biosynthetic group. Propensity-matched analysis in clean-contaminated and contaminated cases showed no significant difference between biosynthetic mesh and polypropylene mesh groups for 30-day surgical site occurrences (20.7% vs 16.7% p = 0.49) or unplanned readmission (13.8% vs 9.8% p = 0.4). Biosynthetic meshes were used in 8.5% (175 of 2,051) of elective OVHR, with the majority (57.1%) used in low-risk or comorbid clean cases. Association of mesh type with 30-day wound events in clean-contaminated or contaminated wounds was investigated using a 1:3 propensity-matched analysis. All elective, OVHR with biosynthetic mesh or uncoated polypropylene mesh from January 2013 through October 2016 were identified within the Americas Hernia Society Quality Collaborative. Here we evaluate the use of biosynthetic mesh and polypropylene mesh in elective open ventral hernia repair (OVHR) and investigate differences in early wound morbidity after OVHR within clean-contaminated and contaminated cases. However, information about the use of biosynthetic meshes and their outcomes compared with polypropylene meshes in clean-contaminated and contaminated cases is lacking. Recently introduced slow-resorbing biosynthetic and non-resorbing macroporous polypropylene meshes are being used in hernias with clean-contaminated and contaminated wounds. ![]() Sahoo, Sambit Haskins, Ivy N Huang, Li-Ching Krpata, David M Derwin, Kathleen A Poulose, Benjamin K Rosen, Michael J Early Wound Morbidity after Open Ventral Hernia Repair with Biosynthetic or Polypropylene Mesh. ![]()
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