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19.01.2021 | Review

Ventral hernia repair with synthetic mesh in a contaminated field: a systematic review and meta-analysis

verfasst von: M. P. Morris, J. A. Mellia, A. N. Christopher, M. N. Basta, V. Patel, K. Qiu, R. B. Broach, J. P. Fischer

Erschienen in: Hernia | Ausgabe 4/2021

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Abstract

Purpose

The use of mesh in ventral hernia repair becomes especially challenging when associated with a contaminated field. Permanent synthetic mesh use in this setting is currently debated and this discussion is yet to be resolved clinically or in the literature. We aim to systematically assess postoperative outcomes of non-absorbable synthetic mesh (NASM) used in ventral hernia repair in the setting of contamination.

Methods

A literature search of PubMed, Embase, Scopus, Cinahl, and Cochrane Library identified all articles from 2000–2020 that examined the use of NASM for ventral hernia repair in a contaminated field. Postoperative outcomes were assessed by means of pooled analysis and meta-analysis. Qualitative analysis was completed for all included studies using a modified Newcastle–Ottawa scale.

Results

Of 630 distinct publications and 104 requiring full review, this study included 17 articles published between 2007 and 2020. Meta-analysis demonstrated absorbable mesh was associated with more HR (OR 1.89, 1.15–3.12, p = 0.008), SSO (OR 1.43, 0.96–2.11, p = 0.087), SSI (OR 2.84, 1.85–4.35, p < 0.001), and unplanned reoperation (OR 1.99, 1.19–3.32, p = 0.009) compared to NASM.

Conclusion

The use of NASM for ventral hernia repair in a contaminated field may be a safe alternative to absorbable mesh, as evidenced by lower rates of postoperative complications. This review counters the current clinical paradigm, and additional prospective randomized controlled trials are warranted.

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Titel: Ventral hernia repair with synthetic mesh in a contaminated field: a systematic review and meta-analysis
verfasst von: M. P. Morris
J. A. Mellia
A. N. Christopher
M. N. Basta
V. Patel
K. Qiu
R. B. Broach
J. P. Fischer
Publikationsdatum: 19.01.2021
Verlag: Springer Paris
Erschienen in: Hernia / Ausgabe 4/2021
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-020-02358-5

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Abstract

Purpose

Methods

Results

Conclusion

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