Evidence map›Paper›PMID 40327184›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2025

Risk of adverse outcomes by plug and flat mesh following 90,319 open inguinal hernia repairs.

Maria M Korah, Priscilla H Chan, Heather A Prentice, Kenneth Sucher, Cheryl L Park, Gregory M Heitmann, Elizabeth W Paxton, Rouzbeh Mostaedi, Elliott R Brill

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Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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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

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Maria M KorahDivision of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA.
Priscilla H ChanMedical Device Surveillance & Assessment, Southern California Permanente Medical Group, San Diego, CA, USA.
Heather A PrenticeMedical Device Surveillance & Assessment, Southern California Permanente Medical Group, San Diego, CA, USA.
Kenneth SucherMedical Device Surveillance & Assessment, Southern California Permanente Medical Group, San Diego, CA, USA.
Cheryl L ParkDepartment of Surgery, Southern California Permanente Medical Group, Woodland Hills, CA, USA.
Gregory M HeitmannDepartment of Surgery, Southern California Permanente Medical Group, Woodland Hills, CA, USA.
Elizabeth W PaxtonMedical Device Surveillance & Assessment, Southern California Permanente Medical Group, San Diego, CA, USA.
Rouzbeh MostaediDepartment of Surgery, The Permanente Medical Group, Richmond, CA, USA.
Elliott R BrillDepartment of Surgery, The Permanente Medical Group, Santa Clara, CA, USA. Elliott.R.Brill@kp.org.ORCID 0000-0001-6182-3113

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe sought to evaluate the risks for reoperation, recurrence, and groin pain following open inguinal hernia repair with a plug versus flat mesh.

methodsWe conducted a cohort study including 90,319 patients ≥ 18 years who underwent first elective open inguinal hernia repair with polyester/polypropylene mesh within a US integrated healthcare system (1/2010-6/2023). Plug versus flat mesh were the treatment groups. Reoperation related to the index hernia repair, as well as other reoperation reasons, and recurrence during follow-up were primary outcomes, while 5-year postoperative groin pain (excluding first 6-month postoperative acute recovery period) was a secondary outcome. Multiple Cox regression was used to evaluate risk of longitudinal outcomes, while multiple logistic regression was used to evaluate groin pain, with covariate adjustment.

resultsPlugs were used in 37,490 (41.5%) repairs; plug use declined from 53.0% in 2010 to 13.9% in the first six months of 2023. No difference in risk for reoperation (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 0.92-1.16) or recurrence (HR = 0.93, 95% CI = 0.83-1.04) was found for plug compared to flat mesh. A higher risk of reoperation for device infection was observed with plug use compared to flat mesh (HR = 2.71, 95% CI = 1.09-6.77). In adjusted analysis, no difference in the likelihood of groin pain was observed (odds ratio = 1.08, 95% CI = 1.00-1.17).

conclusionPlug mesh for open inguinal hernia repairs were not found to have improved outcomes compared to flat mesh but a higher risk of reoperation for infection. These findings align with the current literature, which generally advises against the use of mesh plugs due to associated risks and complications.

Indexed as

Hernia, InguinalHerniorrhaphyPostoperative ComplicationsPostoperative PainSurgical MeshAdultAgedFemaleHumansMaleMiddle AgedPolypropylenesRecurrenceReoperationRetrospective StudiesPolypropylenesFlatInfectionInguinal HerniaMeshPlugRecurrenceReoperation

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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.