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. 2020 Apr;90(4):542-546.
doi: 10.1111/ans.15587. Epub 2019 Dec 14.

Comparison of biosynthetic versus synthetic mesh in clean and contaminated ventral hernia repairs

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Comparison of biosynthetic versus synthetic mesh in clean and contaminated ventral hernia repairs

Kandice Keogh et al. ANZ J Surg. 2020 Apr.

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Abstract

Background: Abdominal hernias are an increasingly common presentation due to obesity, ageing and prevalence of prior abdominal surgery. Mesh repair is the mainstay of treatment; however, mesh selection remains largely subjective. There are little data available to assess the performance of biosynthetic meshes against synthetic meshes across all wound types. This study assessed the 6-month outcomes of a single surgeon's cohort of ventral hernia repairs performed with either GORE BIO-A (BioA) or Parietex ProGrip (ProGrip).

Methods: Retrospective case cohort study across two centres with patients undergoing repair by a single surgeon (KS) between January 2014 and April 2018 was conducted. All hernia repairs were performed with either BioA (n = 55) or ProGrip mesh (n = 60). Outcomes were monitored for 6 months post repair. Wounds were classified according to the Centre for Disease Control Wound Status. Outcomes measured were length of stay, general complications, wound complications and hernia recurrence.

Results: The overall complication rate and length of stay were similar for both groups. In clean wounds, the complication rate was equivalent for BioA and ProGrip (34% versus 22%, P = 0.22). There was a significant difference in complication rates in contaminated wounds - BioA 17% versus ProGrip 100% (P = 0.004). BioA performed equivocally in clean and contaminated wounds (34% versus 17%, P = 0.178), whereas ProGrip performed worse in contaminated wounds (22% versus 100%, P = 0.016).

Conclusion: Our results suggest that BioA is a suitable, if not preferable, choice for contaminated hernia repair. In this cohort, BioA was also demonstrated as safe and equivalent to ProGrip mesh in clean hernia wounds.

Keywords: BioA; biosynthetic mesh; contaminated; hernia repair.

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