Evidence map›Paper›PMID 32060746›Full record

ArticleSurgical endoscopy2021

Implantation of biologic mesh in ventral hernia repair-does it make sense?

Abdelkader Taibi, Sophiane Derbal, Sylvaine Durand Fontanier, Niki Christou, Fabien Fredon, Stephane Bouvier, Anne Fabre, Thibaud Rivaille, Denis Valleix, Muriel Mathonnet

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
2.5field-weighted citation impact, top 11% of its field
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

5 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Observational
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Abdelkader Taibi *Visceral Surgery Department, Limoges University Hospital, Limoges, France. abdelkader.taibi@hotmail.Fr.ORCID 0000-0002-1036-6474
Sophiane Derbal *Visceral Surgery Department, Limoges University Hospital, Limoges, France.
Sylvaine Durand FontanierVisceral Surgery Department, Limoges University Hospital, Limoges, France.
Niki ChristouVisceral Surgery Department, Limoges University Hospital, Limoges, France.
Fabien FredonVisceral Surgery Department, Limoges University Hospital, Limoges, France.
Stephane BouvierVisceral Surgery Department, Limoges University Hospital, Limoges, France.
Anne FabreVisceral Surgery Department, Limoges University Hospital, Limoges, France.
Thibaud RivailleVisceral Surgery Department, Limoges University Hospital, Limoges, France.
Denis ValleixVisceral Surgery Department, Limoges University Hospital, Limoges, France.
Muriel MathonnetVisceral Surgery Department, Limoges University Hospital, Limoges, France.
Université de Limoges · FRCentre National de la Recherche Scientifique · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBiological acellular porcine dermis mesh, such as Permacol™, has been used since 2009 to treat abdominal incisional hernias in a septic context. This study investigated the risk factors for incisional hernia recurrence after biological mesh augmentation.

resultsOver a period of 6 years from February 2009 to February 2015, 68 patients underwent surgery. The mesh was placed intraperitoneally with closure of the anterior fascia in 27 cases (39.7%). The biological mesh was placed in the retromuscular pre-fascial plane in 1 case (1.5%) and pre-aponeurotic plane in 1 case (1.5%). Closure of the anterior fascia was not achieved in 39 cases, including 20 cases in which the mesh was placed intraperitoneally (intraperitoneal bridging group, 29.4%) and 19 cases in which the mesh was placed between the edges of the fascia (inlay bridging group, 27.9%). There were 37 cases of postoperative surgical site infections (54.4%), and Clavien-Dindo morbidity staging indicated stage I-II and III-IV complications in 19.1% and 44.1% of the cases, respectively. The recurrence rate was 61.8%, and the mortality rate was 0%. The rate of recurrence was significantly lower in the «fascia approximated» group (37%), p = 0.001). Univariate analyses of risk factors for procedural failure indicated an increased risk of recurrence in cases of postoperative surgical site infections, complications of Clavien-Dindo grade III or higher, an absent fascial closure in front of the mesh (OR = 8.69), an operating time longer than 180 min, and a VHWG score higher than 2. After logistic regression, the risk factors for recurrence were postoperative infections (OR = 6.2), placement of bridged biological mesh (OR = 22.3), and postoperative morbidity grade III or higher (OR = 16.7).

conclusionsPatients with postoperative surgical site infections are at an increased risk for recurrence, and bridged mesh placements lack efficacy. Overall, this study challenges the purported advantage of biologics in treating incisional hernia repairs.

Indexed as

AdultAgedAged, 80 and overAnimalsFemaleHernia, VentralHerniorrhaphyHumansMaleMiddle AgedSurgical MeshSwineBiological meshBridgeIncisional herniaPorcine dermis meshRecurrence

Identifiers

PMID32060746
OpenAlexW3005961479

What OpenQuestion holds

Textmetadata
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.