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

Abstract

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.

Ventral hernia: Patient selection, treatment, and management

“…Placement of prosthetic material in contaminated situations may increase the risk of SSI (particularly deep, organ space SSI) due to inability to clear contamination from the prosthetic material, creating a potential space for infection or causing mesh erosion and fistula formation. 107 A large database study suggests that mesh reinforcement of contaminated ventral hernia repairs compared to suture repair increases rates of SSI and 30-day complications (OR for SSI 1.2, 95%CI 0.6-2.4). 75 Overall, suture repair lowers the risk of infection but at the cost of increased recurrence rates.…”

Ventral hernia repair with lateral component separation and onlay Biodesign graft

“…Darehzerechki et al [16] performed a systematic review of studies comparing biologic mesh against non-biologic mesh in ventral hernia repairs in clean surgical wounds. The review and subsequent meta-analysis confirmed equivocal rates of recurrence between the biological (18.6 %) and non-biological (15.7 %) groups.…”

“…Post-operatively, length of inpatient stay, complications, reoperation, and follow-up period were recorded. Definitions of complications corresponded with current literature [16]. Hernia recurrence was defined as post-operative hernia, laxity, bulge, or diastasis.…”

Use of Biologic Grafts in Surgery

“…When biologic mesh was compared to nonbiologic mesh in a recent meta-analysis, it was found that biologic grafts had signifi cantly fewer infectious wound complications ( p < 0.00001); however, recurrence rates were not different. In addition, there were no differences in wound infections, and recurrence between the human and porcine-derived biologic grafts [ 30 ].…”