Predictors of 30‐ and 90‐Day Readmissions After Complex Abdominal Wall Reconstruction With Biological Mesh: A Longitudinal Study of 232 Patients

Gogna, Shekhar; Latifi, Rifat; Choi, James; Con, Jorge; Prabhakaran, Kartik; Smiley, Abbas; Anderson, Patrice

doi:10.1007/s00268-020-05714-9

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…Three studies were prospective [63][64][65][66], one included a mix of prospectively enrolled and retrospectively studies participants [67] and 47 studies were retrospective cohort studies (Table 2). Eight studies included only patients with contaminated fields [63,69,72,79,81,106,112,115].…”

Section: Methodologic Aspectsmentioning

confidence: 99%

“…The pooled average HLOS was 8.8 days (95% CI: 6.4-11.2 days, I 2 = 0.0%, p = 1.000). Evidence from MVR studies was not sufficient to identify risk factors for reoperation, readmission or HLOS[67,99,100]. Pooled mortality in 9 studies (aggregate n = 1,216) was estimated at 2.7% (95% CI: 1.2-4.2%, study-specific range: 0.6-6.7%).…”

mentioning

confidence: 99%

“…Fifteen studies conducted MVR analysis in an exploratory fashion[64,65,67,70,73,74,82,83,85,86,88,90,93,99,100,103,107,108,113,119,123].…”

mentioning

confidence: 99%

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Biologic Mesh in Surgery: A Comprehensive Review and Meta‐Analysis of Selected Outcomes in 51 Studies and 6079 Patients

2021

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Background In recent decades, biologic mesh (BM) has become an important adjunct to surgical practice. Recent evidence‐based clinical applications of BM include but are not limited to: reconstruction of abdominal wall defects; breast reconstruction; face, head and neck surgery; periodontal surgery; other hernia repairs (diaphragmatic, hiatal/paraesophageal, inguinal and perineal); hand surgery; and shoulder arthroplasty. Prior systematic reviews of BM in complex abdominal wall hernia repair had several shortcomings that our comprehensive review seeks to address, including exclusion of laparoscopic repair, assessment of risk of bias, use of an acceptable meta‐analytic method and review of risk factors identified in multivariable regression analyses. Materials and methods We sought articles of BM for open ventral hernia repair reporting on early complications, late complications or recurrences and included minimum of 50. We used the quality in prognostic studies risk of bias assessment tool. Random effects meta‐analysis was applied. Results This comprehensive review selected 62 articles from 51 studies that included 6,079 patients. Meta‐analytic pooling found that early complications are present in about 50%, surgical site occurrences (SSOs) in 37%, surgical site infections (SSIs) in 18%, reoperation in 7%, readmission in 20% and mortality in 3%. Meta‐analytic estimates of late outcomes included overall complications (42%), SSOs (40%) and SSIs (22%). Specific SSOs included seroma (14%), hematoma (4%), abscess (10%), necrosis (5%), dehiscence (8%) and fistula formation (5%). Reoperation occurred in about 17%, mesh explantation in 9% and recurrence in 36%. Conclusion Estimates of nearly all outcomes from individual studies were highly heterogeneous and sensitivity analyses and meta‐regressions generally failed to explain this heterogeneity. Recurrence is the only outcome for which there are consistent findings for risk factors. Bridge placement of BM is associated with higher risk of recurrence. Prior hernia repair, history of reintervention and history of mesh removal were also risk factors for increased recurrence.

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