In:
Aesthetic Surgery Journal Open Forum, Oxford University Press (OUP)
Kurzfassung:
Mesh implants are frequently employed in alloplastic breast reconstruction. Notably, no mesh to date has FDA approval for this indication. Several synthetic meshes have been introduced with heterogeneous properties and outcomes. Objectives This study aims to systematically review synthetic mesh use in alloplastic breast reconstruction, describe rates of short-term complications, and analyze these outcomes in reports comparing synthetic and biologic meshes. The authors hypothesized data from comparative and non-comparative studies would show no significant differences between synthetic and biological meshes. Methods The authors conducted a systematic literature review following PRISMA guidelines. Thirty-one studies reporting the use of synthetic mesh and clinical outcomes were included. Eight studies directly comparing synthetic mesh and biological mesh were meta-analyzed for relative risk. Nineteen non-comparative studies were analyzed for meta-rates. Outcomes including seroma, infection, reoperation, and explant were assessed on a per-breast basis. Resultant models were challenged for sensitivity and bias. Results Meta-analysis of comparative studies demonstrated no difference in risk of infection with synthetic mesh (RR=0.53; 95%CI [0.26, 1.10]), but a reduced risk of reoperation (RR= 0.54; 95%CI [0.33, 0.89] ) or explant (RR=0.43; 95%CI [0.21, 0.87]). Meta-analysis of non-comparative studies demonstrated rates of seroma = 3%; 95%CI [1%, 6%] , infection = 4%; 95%CI [3%, 6%], reoperation = 10%; 95%CI [7%, 13%] , and explant = 3%; 95%CI [2%, 5%]). Conclusions Studies comparing synthetic and biologic meshes demonstrated non-inferiority of synthetic in all outcomes assessed. Non-comparative studies demonstrated rates of seroma, infection, reoperation, and explant similar to literature values for biological mesh.
Materialart:
Online-Ressource
ISSN:
2631-4797
DOI:
10.1093/asjof/ojae066
Sprache:
Englisch
Verlag:
Oxford University Press (OUP)
Publikationsdatum:
2024
ZDB Id:
3036519-3
