title: Biologic mesh versus synthetic mesh in open inguinal hernia repair: system review and meta-analysis.
abstract: BACKGROUND
  Biologic meshes are mostly used for abdominal wall reinforcement in infected fields, but no consensus has been reached on its use for inguinal hernia repairing. The purpose of this study was to compare biologic mesh with synthetic mesh in open inguinal herniorrhaphy.
  
  
  METHODS
  A systematic literature review and meta-analysis was undertaken to identify studies comparing the outcomes of biologic mesh and synthetic mesh in open inguinal hernia repair. Published studies were identified by the databases PubMed, EMBASE and the Cochrane Library.
  
  
  RESULTS
  A total of 382 patients in five randomized controlled trials were reviewed (179 patients in biologic mesh group; 203 patients in synthetic mesh group). The two groups did not significantly differ in chronic groin pain (P = 0.06) or recurrence (P = 0.38). The incidence of seroma trended higher in biologic mesh group (P = 0.03). Operating time was significantly longer with biologic mesh (P = 0.03). There was no significant difference in hematomas (P = 0.23) between the two groups.
  
  
  CONCLUSIONS
  From the data of this study, biologic mesh had no superiority to synthetic mesh in open inguinal hernia repair with similar recurrence rates and incidence of chronic groin pain, but higher rate of seroma and longer operating time. However, this mesh still needs to be assessed in a large, multicentre, well-designed randomized controlled trial.
authors.affiliation: Department of Geriatrics Surgery, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Zhixue
authors.initials: Z
authors.lastname: Fang
authors.affiliation: Department of Geriatrics Surgery, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Ren
authors.affiliation: Department of Geriatrics Surgery, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Tian
mesh_terms: D001688:Biological Products / Q000627:therapeutic use*; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013526:Surgical Mesh
chemical_list: D001688:Biological Products
keywords: biologic mesh; hernia; mesh; open inguinal hernia repair; synthetic mesh