title: Biologic grafts for ventral hernia repair: a systematic review.
abstract: BACKGROUND
  Biologic grafts hold promise of a durable repair for ventral hernias with the potential for fewer complications than synthetic mesh. This systematic review was performed to evaluate the effectiveness and safety of biologic grafts for ventral hernia repair.
  
  
  METHODS
  MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched for studies on biologic grafts for the repair of ventral hernias. Outcomes are presented as weighted pooled proportions.
  
  
  RESULTS
  Twenty-five retrospective studies were included. Recurrence depended on wound class, with an overall rate of 13.8% (95% confidence interval [CI], 7.6-21.3). The recurrence rate in contaminated/dirty repairs was 23.1% (95% CI, 11.3-37.6). Abdominal wall laxity occurred in 10.5% (95% CI, 3.7-20.3) of patients. The surgical morbidity rate was 46.3% (95% CI, 33.3-59.6). Infection occurred in 15.9% (95% CI, 9.8-23.2) of patients but only led to graft removal in 4.9% of cases.
  
  
  CONCLUSIONS
  No randomized trials are available to properly evaluate biologic grafts for ventral hernia repair. The current evidence suggests that biologic grafts perform similarly to other surgical options. Biologic grafts are associated with a high salvage rate when faced with infection.
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, The Netherlands. n.slater@chir.umcn.nl
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Slater
authors.forename: Marion
authors.initials: M
authors.lastname: van der Kolk
authors.forename: Thijs
authors.initials: T
authors.lastname: Hendriks
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
authors.forename: Robert P
authors.initials: RP
authors.lastname: Bleichrodt
mesh_terms: D062088:Acellular Dermis / Q000706:statistics & numerical data; D001672:Biocompatible Materials / Q000191:economics / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D006555:Hernia, Ventral / Q000401:mortality / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D012008:Recurrence; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D014183:Transplantation, Heterologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: C440568:Alloderm; D001672:Biocompatible Materials; C422414:Permacol; D003094:Collagen