Cost analysis of incisional hernia repair with synthetic mesh and biological mesh: an Italian study

Abstract Aim Adhesions are fibrous bands of scar tissue that form following peritoneal injury, commonly intra-abdominal surgery, and are associated with serious morbidity such as small bowel obstruction and pain. Surgical meshes used for incisional hernia repair are associated with increased incidence and severity of adhesions. There is limited consensus on which mesh may induce the least adhesions following incisional hernia repair, and most previous data has come from experimental animal models. We aimed to evaluate existing primary research to investigate whether biological mesh limits adhesion formation compared to synthetic or biosynthetic mesh when used in patients for incisional hernia repair and also to assess whether there is correlation with existing animal model data. Material and Methods A systematic search was conducted on PubMed and EMBASE. The number of mesh-related adhesions, character of adhesions and adhesion-related complications were documented. Results were compared to previously published results from animal models. Results Thirty-two studies were included, 11 of which did not document whether the adhesions were mesh related. A total of 14,161 participants underwent incisional hernia repair, 8,526 of whom were included in follow-up analysis. Overall, 9.7% developed adhesions. Biological mesh induced a high rate of dense adhesions, whereas biosynthetic mesh induced loose, filmy adhesions suggested to cause fewer complications. These findings were similar to findings from experimental animal models. Conclusions Bio-synthetic mesh was superior in causing fewer and less dense adhesions. Further analysis of mesh-induced adhesion formation on a larger scale is required to fully understand the consequences of different mesh types.

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Cost analysis of incisional hernia repair by suture or mesh

Hernia ◽

10.1007/s10029-003-0119-z ◽

2003 ◽

Vol 7 (3) ◽

pp. 114-117 ◽

Cited By ~ 24

Author(s):

L. A. Israelsson ◽

L. J�nsson ◽

A. Wimo

Keyword(s):

Incisional Hernia ◽

Cost Analysis ◽

Hernia Repair ◽

Incisional Hernia Repair

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C-reactive protein is a predictive factor for complications after incisional hernia repair using a biological mesh

Scientific Reports ◽

10.1038/s41598-021-83663-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Julien Janet ◽

Sophiane Derbal ◽

Sylvaine Durand Fontanier ◽

Stephane Bouvier ◽

Niki Christou ◽

...

Keyword(s):

Postoperative Complications ◽

Incisional Hernia ◽

Hernia Repair ◽

Incisional Hernia Repair ◽

Biological Mesh ◽

C Reactive Protein ◽

Hernia Surgery ◽

Reactive Protein ◽

Wbc Count ◽

Complications And Mortality

AbstractThe introduction of biological or absorbable synthetic meshes has provided an alternative to conventional repair for incisional hernia. The ability to predict the development of complications after hernia surgery is important, as it guides surgical planning and patient management. This retrospective study assessed whether the postoperative C-reactive protein (CRP) level can predict complications after incisional hernia repair using biological mesh reinforcement. Patients who underwent incisional hernia repair surgery using biological meshes between February 2009 and February 2015 were screened for study inclusion. Patients included in the study were divided into two groups: those with and without postoperative complications. The two groups were analysed based on sex, surgical operation, length of intensive care unit stay (ICU), complications and mortality. Laboratory values, including white blood cell (WBC) count and CRP levels, were determined preoperatively and up to postoperative day (POD) 10. Postoperative complications requiring further management occurred in 32 of the 60 patients (53.3%). Among 47 patients, the mean CRP and WBC levels were 6.6 mg/L and 9.073 G/L in the group without complications vs. 141.0 mg/L, 16.704 G/L in the group with complications (p < 0.001). Patients with complications also had a longer ICU stay (10.1 vs. 0.6 days, p < 0.0001). A cut-off was 101 mg/L and offered 80.00% sensitivity (IC 61.43% to 92.29) and 95.24% specificity (76.18% to 99.88%) for postoperative complication. The rate of postoperative complications before POD10 was 95% in the group with CRP > 100 mg/L vs. 46% in the group with CRP < 100 mg/L (p = 0.000372). A high postoperative CRP level (> 100 mg/L) up to POD10 may serve as a predictor of postoperative complications in patients undergoing incisional hernia using biological meshes.

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