Evidence map›Paper›PMID 41111736›Full record

ReviewCureus2025

Efficacy of Biological Versus Synthetic Mesh in Ventral Hernia Repair: A Systematic Review and Meta-Analysis of Long-Term Outcomes and Recurrence Rates.

Arif Khan, Sarah Elmadbouh, Sibthein A Khalid, Mohid Ayub, Sufyan Mahmood, Kapilraj Ravendran

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
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

6 authors.

Arif KhanGeneral Medicine, Wirral University Teaching Hospital, Wirral, GBR.
Sarah ElmadbouhSpinal Surgery, Royal National Orthopaedic Hospital, London, GBR.
Sibthein A KhalidSurgery, Royal National Orthopaedic Hospital, London, GBR.
Mohid AyubSurgery, NHS England, Leeds, GBR.
Sufyan MahmoodSurgery, Plovdiv Medical University, Plovdiv, BGR.
Kapilraj RavendranSurgery, East and North Hertfordshire NHS Trust, Stevenage, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ventral hernia repair commonly employs either biologic or synthetic mesh, yet the optimal choice remains debated. This systematic review and meta-analysis aimed to compare clinical outcomes such as infection, recurrence, and reoperation rates between biologic and synthetic mesh in ventral hernia repair.  Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across MEDLINE, Cochrane Library, and EMBASE. Randomized controlled trials (RCTs) comparing biologic and synthetic mesh outcomes in adult ventral hernia repair were included. Risk of bias was assessed using the Risk of Bias 2 (ROBINS-II) tool. Pooled analyses used odds ratios (OR) for binary outcomes and weighted mean differences for continuous variables, with heterogeneity evaluated via I² statistics.  Four RCTs were included reporting outcomes for patients receiving biologic (n = 251-378) or synthetic mesh (n = 254-380). Recurrence rates were higher in the biologic mesh group (25.1%) compared to the synthetic group (12.7%) (OR: 2.30; 95% CI: 1.15-4.53; p = 0.01; I² = 73%). Additionally, reoperation rates were higher with biologic mesh (16.9%) versus synthetic mesh (10.4%), but this difference was not statistically significant (OR: 1.94; 95% CI: 1.06-2.44; p = 0.38; I² = 0%). Mesh infection incidence was also slightly higher with biologic mesh (4.8%) than with synthetic mesh (3.1%) (OR: 2.33; 95% CI: 0.64-3.73; p = 0.65; I² = 0%). However, no significant difference in mean patient age was observed between the groups (mean difference: -0.67; 95% CI: -2.78 to 1.44; p = 0.76; I² = 0%). Overall, biologic mesh was associated with a higher hernia recurrence compared to synthetic mesh, while differences in reoperation and mesh infection rates were not statistically significant. These findings suggest that synthetic mesh offers more durable outcomes for ventral hernia repair. Biologic mesh may still be considered selectively in contaminated or high-risk surgical scenarios, but this recommendation is based on limited evidence. Further high-quality RCTs with longer follow-up are needed to better define the optimal mesh choice for varying clinical contexts.

Indexed as

abdomen ventral herniabiologic meshcharacteristics of meshgeneral and colorectal surgeonlaparoscopic ventral hernia repairmesh repairsurgerysynthetic mesh

Identifiers

PMID41111736
PMCPMC12535420

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.