Evidence map›Paper›PMID 23296600›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2013

A critical review of biologic mesh use in ventral hernia repairs under contaminated conditions.

F E Primus, H W Harris

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Diastasis recti abdominis: A comprehensive review.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Stoma closure and reinforcement (SCAR): A study protocol for a pilot trial.Contemporary clinical trials communications · 2020
    Article
  19. Complex abdominal wall hernia repair with biologic mesh in elderly: a propensity matched analysis.Hernia : the journal of hernias and abdominal wall surgery · 2020
    Article
  20. Emergency repair of complicated abdominal wall hernias: WSES guidelines.Hernia : the journal of hernias and abdominal wall surgery · 2020
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

F E PrimusDepartment of Surgery, University of California, San Francisco, CA 94143-0104, USA.
H W Harris

Funding

RESEARCH TRAINING IN GASTROINTESTINAL SURGERYT32DK007573 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HARRIS, HOBART WHITAKER · 1988 to 2019
$3.0M
Lipoproteins and Microbial ImmunityR01GM095967 · NIGMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HARRIS, HOBART WHITAKER · 2010 to 2013
$1.5M
NIDDK NIH HHS DK07573-23NIDDK NIH HHS T32 DK007573NIGMS NIH HHS R01 GM095967
6 · The paper itself

Abstract

purposeWe used an evidence-based approach to determine whether the promotions and claims of superiority of biologic mesh over synthetic mesh use in ventral hernia repairs (VHRs) under contaminated conditions were sound and valid.

methodsWe searched the Medline database to specifically identify review articles relating to biologic mesh and VHR and critically reviewed these studies using an evidence-based approach.

resultsFor the past 45 years, four clinical reviews and one systematic review have included biologic meshes as part of a larger discussion on available prosthetics for VHR. All reviews supported biologic mesh use, especially in the setting of contaminated fields. Yet, the primary literature included in these reviews and served as the basis for these conclusions consisted entirely of case series and case reports, which have the lowest level of evidence in determining scientific validity. Furthermore, the FDA has neither cleared nor approved this particular use.

conclusionsThe cumulative data regarding biologic mesh use in VHRs under contaminated conditions does not support the claim that it is better than synthetic mesh used under the same conditions. The highly promoted and at least moderately utilized practice of placing biologic mesh in contamination is being done outside of the original intended use, and a re-evaluation of or possible moratorium on biologic mesh use in hernia surgery is seriously warranted. Alternatively, an industry-sponsored national registry of patients in whom ventral hernia repairs involved biologic mesh would substantively add to our understanding regarding how these intriguing biomaterials are being used and their overall clinical efficacy.

Indexed as

BioprosthesisHernia, VentralHerniorrhaphyHumansSurgical MeshSurgical Wound Infection

Identifiers

PMID23296600
PMCPMC3601571

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.