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What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

Köckerling, F.; Alam, N. N.; Antoniou, S. A.; Daniels, I. R.; Famiglietti, F.; Fortelny, R. H.; Heiss, M. M.; Kallinowski, F.; Kyle-Leinhase, I. and Mayer, F., et al. (2018) In Hernia 22(2). p.249-269
Abstract

Introduction: Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations. Methods: A European working group, “BioMesh Study Group”, composed of invited surgeons with a special interest in surgical meshes, formulated key questions, and forwarded them for processing in subgroups. In January 2016, a workshop was... (More)

Introduction: Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations. Methods: A European working group, “BioMesh Study Group”, composed of invited surgeons with a special interest in surgical meshes, formulated key questions, and forwarded them for processing in subgroups. In January 2016, a workshop was held in Berlin where the findings were presented, discussed, and voted on for consensus. Findings were set out in writing by the subgroups followed by consensus being reached. For the review, 114 studies and background analyses were used. Results: The cumulative data regarding biologic mesh under contaminated conditions do not support the claim that it is better than synthetic mesh. Biologic mesh use should be avoided when bridging is needed. In inguinal hernia repair biologic and biosynthetic meshes do not have a clear advantage over the synthetic meshes. For prevention of incisional or parastomal hernias, there is no evidence to support the use of biologic/biosynthetic meshes. In complex abdominal wall hernia repairs (incarcerated hernia, parastomal hernia, infected mesh, open abdomen, enterocutaneous fistula, and component separation technique), biologic and biosynthetic meshes do not provide a superior alternative to synthetic meshes. Conclusion: The routine use of biologic and biosynthetic meshes cannot be recommended.

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type
Contribution to journal
publication status
published
subject
keywords
Biologic meshes, Biosynthetic meshes, Bridging, Complex ventral hernias, Contaminated surgical field
in
Hernia
volume
22
issue
2
pages
21 pages
publisher
Springer
external identifiers
  • scopus:85042938237
ISSN
1265-4906
DOI
10.1007/s10029-018-1735-y
language
English
LU publication?
no
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358547cc-2fce-43fd-94a6-793abb78fb22
date added to LUP
2018-05-07 14:59:20
date last changed
2018-09-16 04:55:07
@article{358547cc-2fce-43fd-94a6-793abb78fb22,
  abstract     = {<p>Introduction: Although many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations. Methods: A European working group, “BioMesh Study Group”, composed of invited surgeons with a special interest in surgical meshes, formulated key questions, and forwarded them for processing in subgroups. In January 2016, a workshop was held in Berlin where the findings were presented, discussed, and voted on for consensus. Findings were set out in writing by the subgroups followed by consensus being reached. For the review, 114 studies and background analyses were used. Results: The cumulative data regarding biologic mesh under contaminated conditions do not support the claim that it is better than synthetic mesh. Biologic mesh use should be avoided when bridging is needed. In inguinal hernia repair biologic and biosynthetic meshes do not have a clear advantage over the synthetic meshes. For prevention of incisional or parastomal hernias, there is no evidence to support the use of biologic/biosynthetic meshes. In complex abdominal wall hernia repairs (incarcerated hernia, parastomal hernia, infected mesh, open abdomen, enterocutaneous fistula, and component separation technique), biologic and biosynthetic meshes do not provide a superior alternative to synthetic meshes. Conclusion: The routine use of biologic and biosynthetic meshes cannot be recommended.</p>},
  author       = {Köckerling, F. and Alam, N. N. and Antoniou, S. A. and Daniels, I. R. and Famiglietti, F. and Fortelny, R. H. and Heiss, M. M. and Kallinowski, F. and Kyle-Leinhase, I. and Mayer, F. and Miserez, M. and Montgomery, A. and Morales-Conde, S. and Muysoms, F. and Narang, S. K. and Petter-Puchner, A. and Reinpold, W. and Scheuerlein, H. and Smietanski, M. and Stechemesser, B. and Strey, C. and Woeste, G. and Smart, N. J.},
  issn         = {1265-4906},
  keyword      = {Biologic meshes,Biosynthetic meshes,Bridging,Complex ventral hernias,Contaminated surgical field},
  language     = {eng},
  month        = {04},
  number       = {2},
  pages        = {249--269},
  publisher    = {Springer},
  series       = {Hernia},
  title        = {What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?},
  url          = {http://dx.doi.org/10.1007/s10029-018-1735-y},
  volume       = {22},
  year         = {2018},
}