Biologic grafts for ventral hernia repair: a systematic review.

Abstract

BACKGROUND:

Biologic grafts hold promise of a durable repair for ventral hernias with the potential for fewer complications than synthetic mesh. This systematic review was performed to evaluate the effectiveness and safety of biologic grafts for ventral hernia repair.

METHODS:

MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched for studies on biologic grafts for the repair of ventral hernias. Outcomes are presented as weighted pooled proportions.

RESULTS:

Twenty-five retrospective studies were included. Recurrence depended on wound class, with an overall rate of 13.8% (95% confidence interval [CI], 7.6-21.3). The recurrence rate in contaminated/dirty repairs was 23.1% (95% CI, 11.3-37.6). Abdominal wall laxity occurred in 10.5% (95% CI, 3.7-20.3) of patients. The surgical morbidity rate was 46.3% (95% CI, 33.3-59.6). Infection occurred in 15.9% (95% CI, 9.8-23.2) of patients but only led to graft removal in 4.9% of cases.

CONCLUSIONS:

No randomized trials are available to properly evaluate biologic grafts for ventral hernia repair. The current evidence suggests that biologic grafts perform similarly to other surgical options. Biologic grafts are associated with a high salvage rate when faced with infection.

• Authors: Nicholas J Slater, Marion van der Kolk, Thijs Hendriks, Harry van Goor, Robert P Bleichrodt
• Journal: American journal of surgery (Am J Surg) Vol. 205 Issue 2 Pg. 220-30 (Feb 2013) ISSN: 1879-1883 [Electronic] United States
• PMID: 23200988 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Alloderm
• Biocompatible Materials
• Permacol
• Collagen

Topics

• Acellular Dermis (statistics & numerical data)
• Biocompatible Materials (economics, therapeutic use)
• Collagen (therapeutic use)
• Hernia, Ventral (mortality, surgery)
• Herniorrhaphy (adverse effects, methods, mortality)
• Humans
• Recurrence
• Retrospective Studies
• Surgical Wound Infection (etiology, prevention & control)
• Transplantation, Heterologous
• Transplantation, Homologous
• Treatment Outcome