Repair of incisional hernias with biological prosthesis: A systematic review of current evidence

Charles F. Bellows, Alison Smith, Jennifer Malsbury, William Scott Helton

Research output: Contribution to journalReview articlepeer-review

70 Scopus citations


Background: No consensus has been reached on the use of bioprosthetics to repair abdominal wall defects. The purpose of this systematic review was to summarize the outcomes from studies describing this use of various bioprosthetics for incisional hernia repair. Methods: Studies published by October 2011 were identified through literature searches using EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials. Results: A total of 491 articles were scanned, 60 met eligibility criteria. Most studies were retrospective case studies. The studies ranged considerably in methodologic quality, with a modified Methodological Index of Nonrandomized Studies score from 5 to 12. Many repairs were performed in contaminated surgical sites (47.9%). At least one complication was seen in 87% of repairs. Major complications noted were wound infections (16.9%) and seroma (12.0%). With a mean follow-up period of 13.6 months the hernia recurrence rate was 15.2%. Conclusions: There is an insufficient level of high-quality evidence in the literature on the value of bioprosthetics for incisional hernia repair. Randomized controlled trials that use standardized reporting comparing bioprosthetics with synthetic mesh for incisional hernia repair are needed.

Original languageEnglish (US)
Pages (from-to)85-101
Number of pages17
JournalAmerican journal of surgery
Issue number1
StatePublished - Jan 2013
Externally publishedYes


  • Bioprosthetic
  • Incisional hernia
  • Systematic review

ASJC Scopus subject areas

  • Surgery


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