Alejandro Rodriguez, MD, Jennifer Minneman, MD, Rebecca P Petersen, MD, Andrew S Wright, MD. University of Washington
Background: Biologic grafts are widely used as an alternative to synthetic materials in ventral hernia repair. In the United States, there are currently at least a dozen commercially available biologic grafts. However, the indications for use and individual outcomes are unclear.
Methods: A systematic search was performed using the EMBASE and PubMed platforms. Additional abstracts were identified through other sources. Inclusion criteria were studies describing ventral or incisional hernias, studies with N ≥20, and reporting of basic demographic information and key outcomes (recurrence and wound complications). The PRISMA checklist for systematic reviews was followed.
Results: The search strategy yielded 773 abstracts, with 5 articles being identified through other sources. Seventy-two abstracts were assessed for eligibility. All 30 included studies were retrospective. Outcomes for 2,423 patients were analyzed. Porcine acellular dermal matrix was the most commonly mesh studied followed by human acellular dermal matrix. Recurrence rates ranged from 0 to 35%. Pooled results by mesh type are included in table 1.
Conclusion: The ideal choice of biologic mesh for ventral hernia repair remains unclear. The available literature is characterized by heterogeneity in patient selection and outcomes reporting. Standardized reporting of patient characteristics and clinical outcomes will be crucial in order to guide clinical decision-making.
| Mesh | Studies (n) | Patients (n) | Recurrence (median) | SSO (median) |
| Porcine Acellular Dermal Matrix (non-crosslinked) | 12 | 683 | 8.2% | 28.5% |
| Porcine Acellular Dermal Matrix (crosslinked) | 4 | 927 | 11.3% | 28.7% |
| Human Acellular Dermal Matrix | 10 | 675 | 18.5% | 46.9% |
| Bovine Pericardium | 2 | 64 | 9.6% | 3.2% |
| Bovine Acellular Dermal Matrix | 2 | 74 | 4.1% | 29.9% |
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95892
Program Number: P568
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster