Using surgical mesh with suturing to repair abdominal hernias can reduce recurrence rates in comparison with suturing (rows of stitching) alone, but it increases other surgical risks, according to a review of studies by Mylan T. Nguyen, M.S., of The University of Texas Health Science Center at Houston, and colleagues.
More than 350,000 abdominal hernia repair surgeries occur in the United States annually, of which 75 percent are primary ventral hernias (weakening of the abdominal walls, usually at the navel). Despite the frequency of this surgery, there is insufficient evidence to support the use of sutures alone vs. sutures and mesh for primary ventral hernia repairs, according to the study background.
The authors identified observational studies and clinical trials between 1980 and 2012 which compared the two techniques for elective primary ventral hernia repair (637 mesh and 1,145 suture repairs).
According to study findings, recurrences were fewer with suturing with mesh compared to suture alone repairs (2.7 vs 8.2 percent), but also were associated with higher rates of seromas (pockets of clear fluid that develop after surgery, 7.7 vs 3.8 percent) and surgical site infections (7.3 vs 6.6 percent).
“Additional prospective randomized control trials are warranted to corroborate the findings of this meta-analysis,” the study concludes.
(JAMA Surgery. Published online February 19, 2014. doi:10.1001/jamasurg.2013.5014.