Evidence map›Paper›PMID 29388080›Full record

ReviewHernia : the journal of hernias and abdominal wall surgery2018

What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

F Köckerling, N N Alam, S A Antoniou, I R Daniels, F Famiglietti, R H Fortelny, M M Heiss, F Kallinowski, I Kyle-Leinhase, F Mayer and 13 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Hernia : the journal of hernias and abdominal wall surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 8 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

75 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

F KöckerlingDepartment of Surgery and Center of Minimally Invasive Surgery, Vivantes Hospital, 13585, Berlin, Germany. ferdinand.koeckerling@vivantes.de.
N N AlamDepartment of General Surgery, Manchester Royal Infirmary, Manchester, UK.
S A AntoniouDepartment of General Surgery, University Hospital of Heraklion, Heraklion, Greece.
I R DanielsExeter Surgical Health Services Research Unit, Royal Devon & Exeter Hospital, Exeter, UK.
F FamigliettiDepartment of Abdominal Surgery, University Hospital Gasthuisberg Campus, Louvain, Belgium.
R H FortelnyDepartment of General Surgery, Wilhelminenspital, Medical Faculty, Sigmund Freud University, Vienna, Austria.
M M HeissDepartment of Visceral-, Vascular and Transplantation Surgery, Cologne Merheim Medical Center, University Witten/Herdecke, Cologne, Germany.
F KallinowskiDepartment of General and Visceral Surgery, Regional Hospital Bergstrasse GmbH, Heppenheim, Germany.
I Kyle-LeinhaseDepartment of Surgery, AZ Maria Middelares, Ghent, Belgium.
F MayerDepartment of Surgery, Paracelsus Medical University, Salzburg, Austria.
M MiserezDepartment of Abdominal Surgery, University Hospital Gasthuisberg Campus, Louvain, Belgium.
A MontgomeryDepartment of Surgery, Skåne University Hospital, Malmö, Sweden.
S Morales-CondeUnit of Innovation in Minimally Invasive Surgery, Department of General und Digestive Surgery, University Hospital "Virgen del Rocio", Seville, Spain.
F MuysomsDepartment of Surgery, AZ Maria Middelares, Ghent, Belgium.
S K NarangExeter Surgical Health Services Research Unit, Royal Devon & Exeter Hospital, Exeter, UK.
A Petter-PuchnerAustrian Cluster of Tissue Regeneration, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria.
W ReinpoldDepartment of Surgery and Hernia Center, Wilhelmsburger Hospital "Gross Sand", Hamburg, Germany.
H ScheuerleinDepartment of General and Visceral Surgery, St. Vincenz Hospital, Paderborn, Germany.
M SmietanskiDepartment of Surgery & Hernia Centre, District Hospital in Puck, Medical University of Gdansk, Gdansk, Poland.
B StechemesserHernia Center Cologne, Cologne, Germany.
C StreyDepartment of Surgery, Friederiken-Hospital, Hanover, Germany.
G WoesteDepartment of Surgery, University Hospital, Frankfurt/Main, Germany.
N J SmartExeter Surgical Health Services Research Unit, Royal Devon & Exeter Hospital, Exeter, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAlthough 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. 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. 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.

methodsA European working group, "BioMesh Study Group", composed of invited surgeons with a special interest in surgical meshes, formulated key questions, and forwarded them for processing in subgroups. In January 2016, a workshop was held in Berlin where the findings were presented, discussed, and voted on for consensus. Findings were set out in writing by the subgroups followed by consensus being reached. For the review, 114 studies and background analyses were used.

resultsThe cumulative data regarding biologic mesh under contaminated conditions do not support the claim that it is better than synthetic mesh. Biologic mesh use should be avoided when bridging is needed. In inguinal hernia repair biologic and biosynthetic meshes do not have a clear advantage over the synthetic meshes. For prevention of incisional or parastomal hernias, there is no evidence to support the use of biologic/biosynthetic meshes. 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.

conclusionThe routine use of biologic and biosynthetic meshes cannot be recommended.

Indexed as

AbdominoplastyBiocompatible MaterialsBiological ProductsHerniorrhaphyPostoperative ComplicationsSurgical MeshAbdominal WallConsensusHernia, AbdominalHumansBiocompatible MaterialsBiological ProductsBiologic meshesBiosynthetic meshesBridgingComplex ventral herniasContaminated surgical field

Identifiers

PMID29388080
PMCPMC5978919

What OpenQuestion holds

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Registered trials

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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.