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Open Access 01-04-2018 | Review

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

Authors: F. Köckerling, N. N. Alam, S. A. Antoniou, I. R. Daniels, F. Famiglietti, R. H. Fortelny, M. M. Heiss, F. Kallinowski, I. Kyle-Leinhase, F. Mayer, M. Miserez, A. Montgomery, S. Morales-Conde, F. Muysoms, S. K. Narang, A. Petter-Puchner, W. Reinpold, H. Scheuerlein, M. Smietanski, B. Stechemesser, C. Strey, G. Woeste, N. J. Smart

Published in: Hernia | Issue 2/2018

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 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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Title: What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?
Authors: F. Köckerling
N. N. Alam
S. A. Antoniou
I. R. Daniels
F. Famiglietti
R. H. Fortelny
M. M. Heiss
F. Kallinowski
I. Kyle-Leinhase
F. Mayer
M. Miserez
A. Montgomery
S. Morales-Conde
F. Muysoms
S. K. Narang
A. Petter-Puchner
W. Reinpold
H. Scheuerlein
M. Smietanski
B. Stechemesser
C. Strey
G. Woeste
N. J. Smart
Publication date: 01-04-2018
Publisher: Springer Paris
Published in: Hernia / Issue 2/2018
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-018-1735-y

At a glance: The STEP trials

Springer Medicine

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

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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