Evidence map›Paper›PMID 39666204›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2024

Synthetic vs. biologic mesh for abdominal wall reconstruction in contaminated surgical fields. A meta-analysis of randomized controlled trials and observational studies.

Maximos Frountzas, Despoina Kanata, Eirini Solia, Dimitra Smerdi, Christina Nikolaou, Alexandros Chamzin, Dimitrios Linardoutsos, Dimitrios Theodorou, Konstantinos G Toutouzas, Grigorios Chatzimavroudis and 1 more

Abstract readMeta-AnalysisComparative StudyReview
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In one paragraph

Synthesis in Hernia : the journal of hernias and abdominal wall surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

  1. Pooled it
  2. 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

11 authors.

Maximos FrountzasFirst Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Vas. Sofias Ave. 114, 11527, Athens, Greece. froumax@hotmail.com.ORCID 0000-0001-9157-9860
Despoina KanataFirst Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Vas. Sofias Ave. 114, 11527, Athens, Greece.
Eirini SoliaFirst Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Vas. Sofias Ave. 114, 11527, Athens, Greece.
Dimitra SmerdiFirst Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Vas. Sofias Ave. 114, 11527, Athens, Greece.
Christina NikolaouDepartment of Plastic and Reconstructive Surgery, Gennimatas General Hospital, Athens, Greece.
Alexandros ChamzinFirst Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Vas. Sofias Ave. 114, 11527, Athens, Greece.
Dimitrios LinardoutsosFirst Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Vas. Sofias Ave. 114, 11527, Athens, Greece.
Dimitrios TheodorouFirst Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Vas. Sofias Ave. 114, 11527, Athens, Greece.
Konstantinos G ToutouzasFirst Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration General Hospital, Vas. Sofias Ave. 114, 11527, Athens, Greece.
Grigorios ChatzimavroudisSecond Department of Surgery, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, Thessaloniki, Greece.
Dimitrios SchizasFirst Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBiologic meshes had been the first choice for abdominal wall reconstruction (AWR) in contaminated surgical fields. However, due to increased cost and questioned effectiveness, synthetic meshes have been also implemented. The aim of the present meta-analysis was to compare synthetic and biologic mesh in terms of recurrence and postoperative outcomes.

methodsThe present meta-analysis was designed using the PRISMA guidelines. A search in Medline, Scopus, EMBASE, Clinicaltrials.gov, Google Scholar and Cochrane CENTRAL was conducted from inception until September 2024. Randomized clinical trials (RCTs) and observational studies which compared the use of biologic and synthetic mesh for AWR in contaminated surgical fields were included. Data were extracted by two experienced researchers in pre-defined electronic forms. Pooled odds ratios (OR) and mean differences (MD) were calculated using a random-effects model. Included RCTs were assessed using the Risk of Bias 2 (RoB2) tool and non-randomized trials with the Risk of Bias in non-Randomized Trials (RoBINS-I) tool.

resultsOverall 11 studies were included which enrolled 1,945 patients. Subgroup analysis of RCTs indicated significantly lower recurrence rates for synthetic compared to biologic mesh (p < 0.0001) with a similar follow-up (p = 0.07). Nevertheless, no difference was demonstrated in surgical site infection (SSI) rates. Although synthetic mesh was associated with shorter length of stay, the other postoperative outcomes (surgical site occurrences, mesh infections, readmissions, reoperations) were similar among the two groups.

conclusionSynthetic mesh should be considered as a safe and effective option for abdominal wall reconstruction in contaminated surgical fields compared to biologic mesh. Nevertheless, future research is expected to investigate cost-effectiveness of biosynthetic meshes, as alternative option in such surgical fields.

Indexed as

Abdominal WallSurgical MeshHerniorrhaphyHumansObservational Studies as TopicPlastic Surgery ProceduresRandomized Controlled Trials as TopicRecurrenceSurgical Wound InfectionBiologicContaminatedFieldMeshSynthetic

Identifiers

PMID39666204

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.