ReviewThe role of biologic mesh in abdominal wall reconstruction: a systematic review of the current literature
Section snippets
Why a Systematic Review?
The use of biologic mesh in ventral hernia repair has increased dramatically since its introduction, but most of the published data on the subject exist in retrospective reviews and small case series, which are Level 4 data (Table 1). Systematic reviews are powerful tools for evidence-based medicine practice that methodically and reproducibly examine all the existing published data on a subject. They are considered higher levels of evidence than even randomized controlled trials.4 This
Methods
A systematic review was conducted in November 2010 of the PubMed/Medline databases, using 7 independent searches shown in Table 2. The search methodology used was designed to be inclusive of all possible articles, and include both generic and brand names for biological mesh products. The predetermined inclusion and exclusion criteria are listed in Table 3. The goal of the study was to examine only ventral hernias in the adult population and exclude all other types of abdominal wall–acquired
Results
The systematic review of the current literature yielded a total of 203 articles, and after application of inclusion and exclusion criteria, there were 31 total articles that qualified for the study. One study compared 2 separate devices and is counted only once in the total number of studies. Four studies were found using Permacol (cross-linked porcine acellular dermal matrix; Tissue Science Laboratories, Hampshire, UK), 3 using Surgisis (porcine small intestine submucosa; Cook Medical,
Comments
Complex abdominal wall reconstructions are being performed more frequently by the plastic surgeon secondary to the use of biologic mesh products and the necessity for component separation and soft-tissue manipulation. Acellular dermal matrix has been used since the 1970s for soft-tissue reinforcement, although it has become an accepted and reliable option for hernia repair over the past 8 years. Recent advances include the chemical treatment of the dermal product to include cross-linking and
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The authors have no conflicts of interest.