目的:选择合适的网片加固技术在污染领域进行疝修补是外科医生面临的重要问题。迄今为止,尚未找到用于受污染田地的适当网格。生物合成网已经成为污染领域的新处理选择。这项研究旨在评估生物合成网格在污染领域的术后结果。
方法:系统的电子搜索(PubMed,Medline,Embase,Scopus),根据PRISMA标准,已执行。直到2021年4月,两名审稿人对科学论文进行了文献检索。文章是根据对生物合成网的参考进行选择的,它们在受感染的领域中的使用,在人类主题中。GRADE方法和改良的纽卡斯尔-渥太华量表用于评估研究质量。根据CDC-疾病控制中心的分类,患者被分为两个亚组,第1组(CDC类别2)和第2组(CDC类别3-4)。
结果:本研究共纳入21篇文献,分析1619例患者。长期随访显示复发率明显高于短期随访。P<0.001。这些研究的荟萃分析表明,CDC3-4级的SSI明显高于CDC2级(P<0.01)。两组间SSO(P=0.06)和复发率(P=0.37)差异无统计学意义。Phahix™是15项研究中最常见的网格。平均随访23.0个月。手术部位感染(SSI)率为17.3%。手术部位发生率(SSO)为32.4%。复发率为11.5%。
结论:这是关于在污染感染环境中使用生物合成网片进行腹壁修复的临床结果的首次系统评价和荟萃分析。结果表明,在术后伤口并发症高风险的患者中效果良好。这项研究的目的是在不断增长的生物合成网格文献中添加当前文献证据的图片,以帮助未来的研究人员对该主题进行进一步的研究。
Selection of an appropriate mesh reinforcement for hernia repair in contaminated fields is a significant problem for surgeons. To date the proper mesh for contaminated fields has not been found.
Biosynthetic meshes have emerged as new treatment option in contaminated fields. This study aims to evaluate the postoperative outcomes of
biosynthetic meshes in contaminated fields.
Systematic electronic search (PubMed, Medline, Embase, Scopus), according to PRISMA criteria, was performed. A literature search of scientific papers was performed by two reviewers until April 2021. Articles were chosen based on reference to
biosynthetic meshes, their use in infected fields, and in human subjects. GRADE methodology and the modified Newcastle-Ottawa scale were used to assess the quality of studies. According to CDC-Centers for Disease Control classes patients were divided into two subgroups, group 1 (CDC class 2) and group 2 (CDC classes 3-4).
The research included 21 articles and 1619 patients were analyzed. Long-term follow-up showed a significant higher recurrence rate than short-term follow-up. P < 0.001. Meta-analysis of these studies showed that the SSI were significantly higher in CDC classes 3-4 than CDC class 2 (P < 0.01). No differences were found in SSO (P = 0.06) and recurrence (P = 0.37) rate among the two groups. Phasix™ was the most common mesh in 15 studies. The mean follow-up was 23.0 months. The surgical site infection (SSI) rate was 17.3%. The surgical site occurrence (SSO) rate was 32.4%. Recurrence rate was 11.5%.
This is the first systematic review and meta-analysis on the clinical outcomes of abdominal wall repair using
biosynthetic mesh in contaminated-infected settings. The results show good results in patients at high risk of postoperative wound complications. The aim of this study is to add to the growing literature on
biosynthetic mesh a picture of current literature evidence to help future researchers performing further studies on this topic.