SP7.9 A systematic review and meta-analysis of potentially contaminated and contaminated abdominal wall hernias/defect repair using synthetic versus biological mesh

Abstract Objective The objective of this article is to evaluate the role of synthetic mesh versus biological mesh in repair of potentially contaminated and contaminated abdominal wall hernias/defects. Method Analysis was conducted according to PRISMA guidelines. Systematic search of medical databases like MEBASE, MEDLINE and pubmed was performed to find studies exclusively comparing the use of synthetic mesh versus biological mesh in repairing the potentially contaminated and contaminated complex abdominal wall hernia/defects. Standard medical electronic databases were searched with the help of local librarian and relevant published randomized controlled trials (RCT) were shortlisted according to the inclusion criteria. The analysis of the pooled data was done using RevMan statistical software. Result Three RCTs and 10 comparative studies on 1138 fulfilled the inclusion criteria. In the random effects model analysis, the use synthetic mesh for complex abdominal wall hernia/defect repair in contaminated or potentially contaminated zones reduce the risk of hernia recurrence [odds ratio 0.44, 95% CI (0.33–0.60), z= 5.37, p=0.00001] compared to implantation of biological mesh. Moreover, risk of surgical site infection was statistically higher [odds ratio 0.66, 95% CI (0.47–0.92), z=2.44, p=0.01] following the use of biological mesh. There was no heterogeneity (Tau2 = 0.10; Chi2= 16.15, df = 9 (p=0.06; I2 = 44%) among included studies. Conclusion Use of biological mesh for complex abdominal wall hernia/defect repair in potentially contaminated and contaminated situations failed to demonstrate any superiority over conventional synthetic mesh in both benchmark variables of surgical site infection and hernia recurrence.