title: Use of biological mesh versus standard wound care in infected incisional ventral hernias, the SIMBIOSE study: a study protocol for a randomized multicenter controlled trial.
abstract: BACKGROUND
  In infected incisional ventral hernias (IVHs), the use of a synthetic non-absorbable mesh is not recommended and biological meshes hold promise. However, the level of evidence for their safety and efficacy remains low.
  
  
  METHODS
  The SIMBIOSE trial is a multicenter, phase III, randomized, controlled trial comparing the use of a biological mesh versus traditional wound care in patients with an IVH. The primary end point is 6-month infectious and/or wound morbidity. Secondary end points are wound infection and recurrent hernia rates, post-operative pain, quality of life, time to heal, reoperation need, impact of the cross-linked mesh structure, and a medico-economic evaluation. One hundred patients need to be included.
  
  
  RESULTS
  The main results expected with biological mesh use are a significant decrease of post-operative morbidity, hernia recurrence, time to heal, and costs with an improved quality of life.
  
  
  CONCLUSIONS
  For the first time, the impact of biological meshes in the treatment of IVHs will be evaluated in an academic, randomized, phase III trial to provide scientific evidence (NCT01594450).
  
  
  BACKGROUND
  ClinicalTrial.gov, NCT01594450.
authors.forename: Christophe
authors.initials: C
authors.lastname: Mariette
authors.forename: Nicolas
authors.initials: N
authors.lastname: Briez
authors.forename: Fanette
authors.initials: F
authors.lastname: Denies
authors.forename: Benoît
authors.initials: B
authors.lastname: Dervaux
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Marie
authors.initials: M
authors.lastname: Guilbert
authors.forename: Emilie
authors.initials: E
authors.lastname: Bruyère
authors.forename: William B
authors.initials: WB
authors.lastname: Robb
authors.forename: Guillaume
authors.initials: G
authors.lastname: Piessen
mesh_terms: D000005:Abdomen / Q000601:surgery*; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D005602:France; D017048:Health Care Costs; D006555:Hernia, Ventral / Q000175:diagnosis / Q000191:economics / Q000382:microbiology / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D010149:Postoperative Pain / Q000209:etiology; D011788:Quality of Life; D012008:Recurrence; D012086:Reoperation; D012107:Research Design; D013526:Surgical Mesh / Q000191:economics; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000191:economics / Q000382:microbiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing