title: [Use of biological meshes in abdominal wall reconstruction. Results of a survey in Germany].
abstract: BACKGROUND
  Surgical treatment of incisional hernia includes implantation of a mesh. The use of synthetic grafts in contaminated fields results in an increased risk of infection. In these cases a potential advantage is described for biological repair material. Evidence for this problem is lacking; therefore, we initiated a survey among surgeons in Germany concerning this question.
  
  
  METHODS
  A survey concerning indications, experience and techniques of using synthetic and biological meshes was sent to 60 surgical departments. The emphasis of the survey was on the differentiation of clean and contaminated fields.
  
  
  RESULTS
  The survey was answered by 42 %. The use of biological repair material was preferred in clean-contaminated, contaminated and soiled fields. Synthetic meshes were preferred in clean, rarely in clean-contaminated and not in contaminated or soiled situations. Primary suture repair was chosen in clean fields and barely in contaminated fields. For closure of giant hernias a component separation technique (CST) was favored by the majority of respondents. A single stage repair was preferred by most of the surgeons even in cases with simultaneous stoma takedown. A total of 72 % of the respondents were satisfied with the use of biological repair material, but the reimbursement was considered to be inappropriate.
  
  
  CONCLUSIONS
  Although the response rate was low, this survey gives an idea of the attitude towards the use of synthetic and biological meshes. Biological repair material is favored for hernia repair in contaminated or soiled fields. The advantage of this choice is a one stage repair despite the contamination. As the results of this survey are not able to provide arguments for the use of different meshes this question should be further investigated with a randomized controlled trial.
authors: Klinik für Allgemein- und Viszeralchirurgie, Klinikum der Johann Wolfgang Goethe Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland, guido.woeste@kgu.de.
authors: G
authors: G
authors: Woeste
authors: F-E
authors: FE
authors: Isemer
authors: C W
authors: CW
authors: Strey
authors: H-M
authors: HM
authors: Schardey
authors: H
authors: H
authors: Thielemann
authors: A
authors: A
authors: Mihaljevic
authors: J
authors: J
authors: Kleeff
authors: J
authors: J
authors: Kleef
mesh_terms: D058107:Abdominal Wound Closure Techniques; D001291:Attitude of Health Personnel; D001672:Biocompatible Materials; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D000069290:Incisional Hernia / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000601:surgery; D011795:Surveys and Questionnaires; D013536:Suture Techniques
chemical_list: D001672:Biocompatible Materials