Nip Lawrence, Zhao Sarah, Thomas Rhys, Windsor Alastair C J, Mallett Sue, Halligan Steve, Parker Samuel G
The Abdominal Wall Unit, Croydon University Hospital, London, United Kingdom.
Centre for Medical Imaging, Division of Medicine, University College London, London, United Kingdom.
J Abdom Wall Surg. 2025 May 14;4:14573. doi: 10.3389/jaws.2025.14573. eCollection 2025.
Mesh suture, or Duramesh™, has recently gained attention because of potential advantages over conventional techniques for abdominal wall closure. However, the evidence base for any advantage has not been assessed formally. Via systematic review we evaluated clinical outcomes for mesh suture and its precursor, mesh strip, in clinical trials of abdominal wall closure or ventral hernia repair.
A systematic search of MEDLINE, CENTRAL, Embase, Cochrane, WHO International Clinical Trials Registry, and ClinicalTrials.gov was conducted to identify studies using mesh suture and/or mesh strip. Primary outcome was incisional hernia occurrence after primary closure or recurrence following ventral hernia repair, summarised with median percentage rates. Secondary outcomes included surgical site occurrences and reoperations. Risk of bias was assessed using adapted forms of ROBINS-I and Cochrane RoB2 tools.
Five single-arm case series and one interim report from a randomised controlled trial were eligible for inclusion, reporting 585 patients. Median follow-up was 11.9 months (range 2.7-35.3 months). Median incisional hernia occurrence was 3.4% (range 0%-50%). Median surgical site occurrence was 17.4% (range 0%-50%) and surgical site infection 5.4% (range 0%-19%). Overall, 6.0% patients (33 of 553) returned to theatre to manage complications. Overall risk of bias for included studies was critical.
This systematic review highlights a need for high-quality randomised controlled trials with long-term follow-up to evaluate the clinical benefits of Duramesh™ for abdominal wall closure and ventral hernia repair. Better evidence is required to determine its safety and clinical efficacy.
网片缝合术，即杜拉网片（Duramesh™），因其在腹壁闭合方面相对于传统技术可能具有的优势，最近受到了关注。然而，对于其任何优势的证据基础尚未进行正式评估。通过系统评价，我们评估了网片缝合术及其前身网片条带在腹壁闭合或腹疝修补临床试验中的临床结局。
对MEDLINE、CENTRAL、Embase、Cochrane、世界卫生组织国际临床试验注册平台和ClinicalTrials.gov进行系统检索，以识别使用网片缝合术和/或网片条带的研究。主要结局是一期缝合后切口疝的发生情况或腹疝修补术后的复发情况，以中位数百分比表示。次要结局包括手术部位事件和再次手术。使用改编后的ROBINS-I和Cochrane RoB2工具评估偏倚风险。
五项单臂病例系列研究和一项随机对照试验的中期报告符合纳入标准，共报告了585例患者。中位随访时间为11.9个月（范围2.7 - 35.3个月）。切口疝发生的中位数为3.4%（范围0% - 50%）。手术部位事件的中位数为17.4%（范围0% - 50%），手术部位感染为5.4%（范围0% - 19%）。总体而言，6.0%的患者（553例中的33例）返回手术室处理并发症。纳入研究的总体偏倚风险很高。
本系统评价强调需要进行长期随访的高质量随机对照试验，以评估杜拉网片（Duramesh™）在腹壁闭合和腹疝修补中的临床益处。需要更好的证据来确定其安全性和临床疗效。
