Evidence map›Paper›PMID 37118030›Full record

ReviewSurgical endoscopy2023

Comparative long-term effectiveness between ventral hernia repairs with biosynthetic and synthetic mesh.

Benjamin G Morrison, Kiah Gledhill, Margaret A Plymale, Daniel L Davenport, John S Roth

Abstract readReview
PubMed Publisher
In one paragraph

Review in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

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

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. 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

5 authors.

Benjamin G MorrisonCollege of Medicine, University of Kentucky, Lexington, KY, USA.
Kiah GledhillCollege of Medicine, University of Kentucky, Lexington, KY, USA.
Margaret A PlymaleDivision of General, Endocrine & Metabolic Surgery, Department of Surgery, University of Kentucky, C 240, Chandler Medical Center, 800 Rose Street, Lexington, KY, 40536, USA.
Daniel L DavenportDivision of Health Outcomes and Optimal Patient Services, Department of Surgery, University of Kentucky, Lexington, KY, USA.
John S RothDivision of General, Endocrine & Metabolic Surgery, Department of Surgery, University of Kentucky, C 240, Chandler Medical Center, 800 Rose Street, Lexington, KY, 40536, USA. s.roth@uky.edu.ORCID http://orcid.org/0000-0003-0332-7220

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDebate exists regarding the most appropriate type of mesh to use in ventral hernia repair (VHR). Meshes are broadly categorized as synthetic or biologic, each mesh with individual advantages and disadvantages. More recently developed biosynthetic mesh has characteristics of both mesh types. The current study aims to examine long-term follow-up data and directly compare outcomes-specifically hernia recurrence-of VHR with biosynthetic versus synthetic mesh.

methodsWith IRB approval, consecutive cases of VHR (CPT codes 49,560, 49,561, 49,565, and 49,566 with 49,568) performed between 2013 and 2018 at a single institution were reviewed. Local NSQIP data was utilized for patient demographics, perioperative characteristics, CDC Wound Class, comorbidities, and mesh type. A review of electronic medical records provided additional variables including hernia defect size, postoperative wound events to six months, duration of follow-up, and incidence of hernia recurrence. Longevity of repair was measured using Kaplan-Meier method and adjusted Cox proportional hazards regression.

resultsBiosynthetic mesh was used in 101 patients (23%) and synthetic mesh in 338 (77%). On average, patients repaired using biosynthetic mesh were older than those with synthetic mesh (57 vs. 52 years; p = .008). Also, ASA Class ≥ III was more common in biosynthetic mesh cases (70.3% vs. 55.1%; p = .016). Patients repaired with biosynthetic mesh were more likely than patients with synthetic mesh to have had a prior abdominal infection (30.7% vs. 19.8%; p = .029). Using a Kaplan-Meier analysis, there was not a significant difference in hernia recurrence between the two mesh types, with both types having Kaplan Meir 5-year recurrence-free survival rates of about 72%.

conclusionUsing Kaplan-Meier analysis, synthetic mesh and biosynthetic mesh result in comparable hernia recurrence rates and surgical site infection rates in abdominal wall reconstruction patients with follow-up to as long as five years.

Indexed as

Hernia, VentralSurgical MeshHerniorrhaphyHumansProstheses and ImplantsRetrospective StudiesSurgical Wound InfectionTreatment OutcomeAbdominal wall reconstructionBiosynthetic meshHernia recurrenceRecurrence-free survivalSynthetic meshVentral hernia

Identifiers

PMID37118030

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.