Medical Devices: Evidence and Research (Sep 2019)
Polyester vs polypropylene, do mesh materials matter? A meta-analysis and systematic review
Abstract
Crystal Totten,1 Patrice Becker,2 Mathilde Lourd,2 J Scott Roth1 1Division of General Surgery, Department of Surgery, University of Kentucky, College of Medicine, Lexington, KY 40536-0298, USA; 2Medical Affairs, Medtronic, Sofradim Production, Trevoux 01600, FranceCorrespondence: J Scott RothDivision of General Surgery, Department of Surgery, University of Kentucky Medical Center, 800 Rose Street, C-226 UKMC, Lexington, KY 40536, USATel +1 859 323 6346Fax +1 859 323 6840Email [email protected]: Controversy exists regarding the outcomes following ventral hernia repair with polypropylene (PP) or polyester (PET) mesh. Monofilament PP less frequently requires extraction in the setting of contamination compared to multifilament PET mesh. The purpose of this systematic review and meta-analysis was to analyze the clinical outcomes of ventral hernia repair with PP and PET mesh.Patients and methods: A comprehensive literature search was performed using the Ovid search platform. Criteria included ventral hernia repair publications using either PP or PET mesh with a minimum follow-up duration of one year. Included studies were subject to data extraction including mesh position, weight, recurrence rates, infection, and complications. Random effect meta-analysis was run to provide pooled event rate and 95% CI.Results: Ninety-seven studies including a total of 10,022 patients were included in the final analysis. Hernia recurrence rates are similar (4.8%, 95% CI [3.5–6.5] vs 4.7%, 95% CI [3.7–6.0]) as well as mesh infection rates (3.5%, 95% CI [2.5–4.9] vs 5.0%, 95% CI [3.9–6.3]) between PET and PP, respectively. Mesh infections occurred less frequently in laparoscopic repair compared to open (1.6%, 95% CI [0.9–2.6] vs 5.2%, 95% CI [4.3–6.3]).Conclusion: This study suggests that mesh material does not affect recurrence or infection in ventral hernia repair and that surgery can be safely performed with both PP and PET mesh. A laparoscopic approach is associated with a decreased infection rate compared to open repair independent of mesh type.Keywords: polyester, polypropylene, ventral hernia, recurrence, infection
