Evidence map›Paper›PMID 36319897›Full record

ArticleSurgical endoscopy2023

Outcomes of light and midweight synthetic mesh use in clean-contaminated and contaminated ventral incisional hernia repair: an ACHQC comparative analysis.

Monica E Polcz, Richard A Pierce, Molly A Olson, Joseph Blankush, Meredith C Duke, Joseph Broucek, Joel F Bradley

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Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.0field-weighted citation impact, top 14% 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, 9 citations in OpenAlex.

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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

7 authors at 2 institutions in 1 country.

Monica E PolczDepartment of Surgery, Vanderbilt University Medical Center, 1161 21St Avenue South, D-5203 Medical Center North, Nashville, TN, 37232, USA.
Richard A PierceDepartment of Surgery, Vanderbilt University Medical Center, 1161 21St Avenue South, D-5203 Medical Center North, Nashville, TN, 37232, USA.
Molly A OlsonInstitute for Health Technologies and Interventions, Weill Cornell College of Medicine, New York, NY, USA.
Joseph BlankushDepartment of Surgery, Vanderbilt University Medical Center, 1161 21St Avenue South, D-5203 Medical Center North, Nashville, TN, 37232, USA.
Meredith C DukeDepartment of Surgery, Vanderbilt University Medical Center, 1161 21St Avenue South, D-5203 Medical Center North, Nashville, TN, 37232, USA.
Joseph BroucekDepartment of Surgery, Vanderbilt University Medical Center, 1161 21St Avenue South, D-5203 Medical Center North, Nashville, TN, 37232, USA.
Joel F BradleyDepartment of Surgery, Vanderbilt University Medical Center, 1161 21St Avenue South, D-5203 Medical Center North, Nashville, TN, 37232, USA. Joel.Bradley@vumc.org.ORCID 0000-0001-6452-8013
Vanderbilt University Medical Center · USCornell University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUse of macroporous synthetic mesh in contaminated ventral hernia repair has become more frequent. The objective of this study is to compare the outcomes of ventral incisional hernia repair with permanent synthetic mesh in contaminated fields to those in a clean field.

methodsThe Abdominal Core Health Quality Collaborative registry, a prospectively updated longitudinal hernia-specific national database, was retrospectively queried for adults who underwent open ventral incisional hernia repair using light or medium-weight synthetic mesh and classified as clean (CDC Class I) or contaminated (CDC Class II/III). Univariate analysis was used to compare demographic information, hernia characteristics, and operative details. Odds ratios (OR) were calculated using multivariable logistic regression for the primary outcome of 30-day surgical site infection (SSI) and secondary outcomes of 30-day surgical site occurrence (SSO), SSO requiring procedural intervention (SSO-PI), and clinical recurrence at one year.

results7219 cases met criteria for inclusion; 13.2% of these were contaminated. 83.4% of patients had follow-up data at 30 days and 20.8% at 1 year. The adjusted OR for 30-day SSI in contaminated fields compared to clean was 2.603 (95% CI 1.959-3.459). OR for 30-day SSO was 1.275 (95% CI 1.017-1.600) and 2.355 (95%CI 1.817-3.053) for 30-day SSO-PI. OR for recurrence at one year was 1.489 (95%CI 0.892-2.487). Contaminated cases had higher rates of mesh infection (3.9% vs 0.8%, p < 0.001) and mesh removal (7.3 vs 2.5%, p < 0.001) at 1 year.

conclusionsAfter adjusting for baseline differences, patients undergoing ventral incisional hernia repair using light or midweight synthetic mesh in contaminated fields have higher odds of 30-day SSI, SSO, and SSO-PI than those performed in clean wounds. The odds of recurrence did not statistically differ and further studies with long-term outcomes are needed to better evaluate the best treatment options for this patient population.

Indexed as

Hernia, VentralIncisional HerniaAdultHerniorrhaphyHumansNeoplasm Recurrence, LocalRecurrenceRetrospective StudiesSurgical MeshSurgical Wound InfectionTreatment Outcome

Identifiers

PMID36319897
OpenAlexW4307805264

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.