Evidence map›Paper›PMID 36943520›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2023

Biosynthetic meshes in contaminated fields: where are we now? A systematic review and meta-analysis in humans.

G Perrone, M Giuffrida, E Bonati, G L Petracca, F Catena

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Variable use of modern abdominal wall closure techniques at emergency laparotomy - an international, cross-sectional survey of surgical practice.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  6. Observational
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

G PerroneDepartment of Emergency Surgery, Parma University Hospital, Parma, Italy.
M GiuffridaGeneral Surgery Unit, Department of Medicine and Surgery, Parma University Hospital, Via A. Gramsci 14, 43126, Parma, Italy. mario.giuffrida4@gmail.com.ORCID 0000-0001-8335-3941
E BonatiGeneral Surgery Unit, Department of Medicine and Surgery, Parma University Hospital, Via A. Gramsci 14, 43126, Parma, Italy.
G L PetraccaDepartment of Emergency Surgery, Parma University Hospital, Parma, Italy.
F CatenaDepartment of Emergency and Trauma Surgey, Bufalini Trauma Center, Cesena, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSelection of an appropriate mesh reinforcement for hernia repair in contaminated fields is a significant problem for surgeons. To date the proper mesh for contaminated fields has not been found. Biosynthetic meshes have emerged as new treatment option in contaminated fields. This study aims to evaluate the postoperative outcomes of biosynthetic meshes in contaminated fields.

methodsSystematic electronic search (PubMed, Medline, Embase, Scopus), according to PRISMA criteria, was performed. A literature search of scientific papers was performed by two reviewers until April 2021. Articles were chosen based on reference to biosynthetic meshes, their use in infected fields, and in human subjects. GRADE methodology and the modified Newcastle-Ottawa scale were used to assess the quality of studies. According to CDC-Centers for Disease Control classes patients were divided into two subgroups, group 1 (CDC class 2) and group 2 (CDC classes 3-4).

resultsThe research included 21 articles and 1619 patients were analyzed. Long-term follow-up showed a significant higher recurrence rate than short-term follow-up. P < 0.001. Meta-analysis of these studies showed that the SSI were significantly higher in CDC classes 3-4 than CDC class 2 (P < 0.01). No differences were found in SSO (P = 0.06) and recurrence (P = 0.37) rate among the two groups. Phasix™ was the most common mesh in 15 studies. The mean follow-up was 23.0 months. The surgical site infection (SSI) rate was 17.3%. The surgical site occurrence (SSO) rate was 32.4%. Recurrence rate was 11.5%.

conclusionThis is the first systematic review and meta-analysis on the clinical outcomes of abdominal wall repair using biosynthetic mesh in contaminated-infected settings. The results show good results in patients at high risk of postoperative wound complications. The aim of this study is to add to the growing literature on biosynthetic mesh a picture of current literature evidence to help future researchers performing further studies on this topic.

Indexed as

AbdominoplastyHernia, VentralHerniorrhaphyHumansRecurrenceRetrospective StudiesSurgical MeshSurgical Wound InfectionTreatment OutcomeBiologicalBiosyntheticContaminatedHerniaMeshSurgery

Identifiers

PMID36943520

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.