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Hernia : the Journal of Hernias and... Jun 2021To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses used.
METHODS
A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Cochrane databases was conducted to identify comparative studies until September 2020. A meta-analysis of postoperative outcomes and a network meta-analysis for a multiple comparison of the prostheses with each other were performed.
RESULTS
Seven studies were included in the analysis (78.4% ileostomy and 21.6% colostomy) with a total of 1716 patients with (n = 684) or without (n = 1032) mesh. Mesh placement was associated with lower risk of SSIH (7.8%vs18.1%, OR0.266,95% CI 0.123-0.577, p < 0.001) than no mesh procedures but also with a longer operative time (SMD 0.941, 95% CI 0.462-1.421, p < 0.001). There was no statistically significant difference in terms of Surgical Site infection (11.5% vs 11.1%, OR 1.074, 95% CI 0.78-1.48, p = 0.66), seroma formation (4.4% vs 7.1%, OR 1.052, 95% CI 0.64-1.73, p = 0.84), anastomotic leakage (3.7% vs 2.7%, OR 1.598, 95% CI 0.846-3.019, p = 0.149) and length of stay (SMD - 0.579,95% CI - 1.261 to 0.102, p = 0.096) between mesh and no mesh groups. Use of prosthesis was associated with a significant lower need for a reoperation than no mesh group (8.1% vs 12.1%, OR 0.332, 95% CI 0.119-0.930, p = 0.036). Incidence of seroma is lower with biologic than polypropylene meshes but they showed a trend towards poor results compared with polypropylene or biosynthetic meshes.
CONCLUSION
Despite longer operative time, mesh prophylactic reinforcement at the site of stoma seems a safe and effective procedure with lower incidence of SSIH, need for reoperation and comparable short-term outcomes than standard closure technique. A significant superiority of a specific mesh type was not identified.
Topics: Herniorrhaphy; Humans; Incisional Hernia; Prostheses and Implants; Surgical Mesh; Surgical Stomas
PubMed: 33713204
DOI: 10.1007/s10029-021-02393-w -
Environmental Pollution (Barking, Essex... May 2024Microplastics in drinking water captured widespread attention following reports of widespread detection around the world. Concerns have been raised about the potential... (Review)
Review
Microplastics in drinking water captured widespread attention following reports of widespread detection around the world. Concerns have been raised about the potential adverse effects of microplastics in drinking water on human health. Given the widespread interest in this research topic, there is an urgent need to compile existing data and assess current knowledge. This paper provides a systematic review of studies on microplastics in drinking water, their evidence, key findings, knowledge gaps, and research needs. The data collected show that microplastics are widespread in drinking water, with large variations in reported concentrations. Standardized methodologies of sampling and analysis are urgently needed. There were more fibrous and fragmented microplastics, with the majority being <10 μm in size and composed of polyester, polyethylene, polypropylene, and polystyrene. Little attention has been paid to the color of microplastics. More research is needed to understand the occurrence and transfer of microplastics throughout the water supply chain and the treatment efficiency of drinking water treatment plants (DWTPs). Methods capable of analyzing microplastics <10 μm and nanoplastics are urgently needed. Potential ecological assessment models for microplastics currently in use need to be improved to take into account the complexity and specificity of microplastics.
Topics: Humans; Microplastics; Plastics; Drinking Water; Water Pollutants, Chemical; Environmental Monitoring
PubMed: 38537794
DOI: 10.1016/j.envpol.2024.123857 -
Hernia : the Journal of Hernias and... Apr 2019This study reviewed the literature regarding mesh migration in abdominal hernia repair. The aim of this study is to interrogate incidence, common type of abdominal...
PURPOSE
This study reviewed the literature regarding mesh migration in abdominal hernia repair. The aim of this study is to interrogate incidence, common type of abdominal hernia repair leading to migration, patterns of mesh migration, and materials associated with migration.
METHODS
A comprehensive literature review was conducted. PubMed and MEDLINE were searched for relevant articles in the English literature. We employed Ovid syntax from 1949 to January 2010, the Cochrane Library, Google and Google Scholar. The clinical trial database Clinicaltrials.gov was reviewed. Letters to the editor were reviewed to extract cross-references. Multiple keywords were used alone and in combination to extract all relevant articles.
RESULTS
In total, 287 unique English citations were reviewed. Of these, 84 articles were selected and consisted of 3 case series, 77 case reports, 2 literature reviews, 1 retrospective study, and 1 prospective, observational study. In an analysis of available cases, the average age was 59.8 ± 13.8 years with a male predominance (76.2%). The index hernia repair was inguinal in 62.9%, incisional/ventral in 28.1%, umbilical in 6.7%, and other in 2.2%. Within the inguinal hernia group, 51.8% were open repairs, 42.9% were laparoscopic, and 1.8% were robotic. Implicated mesh materials included polypropylene, PTFE, and composite mesh. Migration commonly affected multiple organs (31.5%).
CONCLUSIONS
It is likely that more cases of mesh migration will appear in the literature. Reports are heterogeneous and highlight the diversity of this complication. A standardized method of reporting is needed to develop guidelines and recommendations for this presentation.
Topics: Foreign-Body Migration; Hernia, Abdominal; Herniorrhaphy; Humans; Surgical Mesh
PubMed: 30701369
DOI: 10.1007/s10029-019-01898-9 -
ASAIO Journal (American Society For... Mar 2023This systematic review summarizes the major developments in extracorporeal membrane oxygenation (ECMO) circuitry in pediatrics over the past 20 years and demonstrates...
This systematic review summarizes the major developments in extracorporeal membrane oxygenation (ECMO) circuitry in pediatrics over the past 20 years and demonstrates the impacts of those developments on clinical outcomes. This systematic review followed structured Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 1987 studies were retrieved, of which 82 were included in the final analysis. Over the past 20 years, ECMO pumps have shifted from roller pumps to centrifugal pumps. Silicone and polypropylene hollow fiber membrane oxygenators were initially used but have been replaced by polymethylpentene hollow fiber membrane oxygenators, with other ECMO components poorly reported. Considerable variability in mortality was found across studies and there was no statistical difference in mortality rates across different periods. The duration of ECMO and other outcome measures were inconsistently reported across studies. This systematic review demonstrated technological developments in pumps and oxygenators over the last two decades, although patient mortality rates remained unchanged. This could be because of ECMO support applied to patients in more critical conditions over the years. We also highlighted the limitations of methodology information disclosure and outcome measures in current ECMO studies, showing the need of reporting standardization for future ECMO studies.
Topics: Humans; Child; Extracorporeal Membrane Oxygenation; Oxygenators
PubMed: 35749749
DOI: 10.1097/MAT.0000000000001785 -
Environmental Pollution (Barking, Essex... May 2024Microplastics pose a significant environmental threat, with potential implications for toxic chemical release, aquatic life endangerment, and human food chain... (Review)
Review
Microplastics pose a significant environmental threat, with potential implications for toxic chemical release, aquatic life endangerment, and human food chain contamination. In Asia, rapid economic growth coupled with inadequate waste management has escalated plastic pollution in rivers, positioning them as focal points for environmental concern. Despite Asia's rivers being considered the most polluted with plastics globally, scholarly attention to microplastics in the region's freshwater environments is a recent development. This study undertakes a systematic review of 228 scholarly articles to map microplastic hotspots in Asian freshwater systems and synthesize current research trends within the continent. Findings reveal a concentration of research in China and Japan, primarily investigating riverine and surface waters through net-based sampling methods. Polyethylene (PE), polypropylene (PP), and polyethylene terephthalate (PET) emerge as the predominant microplastic types, frequently observed as fibers or fragments. However, the diversity of sampling methodologies and reporting metrics complicates data synthesis, underscoring the need for standardized analytical frameworks to facilitate comparative analysis. This paper delineates the distribution of microplastic hotspots and outlines the prevailing challenges and prospects in microplastic research within Asian freshwater contexts.
Topics: Microplastics; Rivers; Environmental Monitoring; Water Pollutants, Chemical; Asia; China; Japan; Plastics
PubMed: 38621450
DOI: 10.1016/j.envpol.2024.123985 -
Environmental Research May 2023Food waste (FW) contains many nutritional components such as proteins, lipids, fats, polysaccharides, carbohydrates, and metal ions, which can be reused in some... (Review)
Review
Food waste (FW) contains many nutritional components such as proteins, lipids, fats, polysaccharides, carbohydrates, and metal ions, which can be reused in some processes to produce value-added products. Furthermore, FW can be converted into biogas, biohydrogen, and biodiesel, and this type of green energy can be used as an alternative to nonrenewable fuel and reduce reliance on fossil fuel sources. It has been demonstrated in many reports that at the laboratory scale production of biochemicals using FW is as good as pure carbon sources. The goal of this paper is to review approaches used globally to promote turning FW into useable products and green energy. In this context, the present review article highlights deeply in a transdisciplinary manner the sources, types, impacts, characteristics, pre-treatment strategies, and potential management of FW into value-added products. We find that FW could be upcycled into different valuable products such as eco-friendly green fuels, organic acids, bioplastics, enzymes, fertilizers, char, and single-cell protein, after the suitable pre-treatment method. The results confirmed the technical feasibility of all the reviewed transformation processes of FW. Furthermore, life cycle and techno-economic assessment studies regarding the socio-economic, environmental, and engineering aspects of FW management are discussed. The reviewed articles showed that energy recovery from FW in various forms is economically feasible.
Topics: Refuse Disposal; Food; Waste Management; Cost-Benefit Analysis; Biofuels; Bibliometrics
PubMed: 36842700
DOI: 10.1016/j.envres.2023.115558 -
Aesthetic Plastic Surgery Mar 2024Implant-based breast reconstruction (IBBR) can be performed using a variety of biological and synthetic meshes. However, there has yet to be a consensus on the optimal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Implant-based breast reconstruction (IBBR) can be performed using a variety of biological and synthetic meshes. However, there has yet to be a consensus on the optimal mesh. This study investigates the safety and patient satisfaction of using TiLOOP® Bra in IBBR and compares its postoperative complication risk with that of porcine acellular dermal matrix (ADM) and SERAGYN® BR.
METHODS
The literature review was performed via PRISMA criteria, 23 studies met the inclusion criteria for the TiLOOP® Bra review, and 5 studies met the inclusion criteria for the meta-analysis. Patient characteristics and per-breast complications were collected. Data were analyzed using Cochrane RevMan and IBM SPSS.
RESULTS
In 3175 breasts of 2685 patients that underwent IBBR using TiLOOP® Bra, rippling was observed as the most common complication, followed by seroma and capsular contracture. No significant difference in the overall complication rate between pre- and sub-pectoral IBBR using TiLOOP® Bra. However, the meta-analysis showed that the TiLOOP® Bra group had significantly lower odds of implant loss, seroma, wound dehiscence, and the need for reoperation or hospitalization than the ADM group. Additionally, the TiLOOP® Bra group had a significantly lower seroma rate compared to the SERAGYN® BR group, while the other outcome indicators were similar between the two groups.
CONCLUSION
TiLOOP® Bra has become increasingly popular in IBBR in recent years. This review and meta-analysis support the favorable safety profile of TiLOOP® Bra reported in the current literature. The meta-analysis revealed that TiLOOP® Bra has better safety than ADM and a comparable risk of complications compared to SERAGYN® BR. However, as most studies had low levels of evidence, further investigations are necessary.
LEVEL OF EVIDENCE III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Animals; Female; Humans; Acellular Dermis; Breast Implantation; Breast Implants; Breast Neoplasms; Mammaplasty; Polypropylenes; Postoperative Complications; Retrospective Studies; Seroma; Surgical Mesh; Swine; Titanium; Treatment Outcome
PubMed: 37464216
DOI: 10.1007/s00266-023-03500-1 -
World Journal of Surgery Jun 2023Surgical mesh infection (SMI) after abdominal wall hernia repair (AWHR) is a challenging and highly debated clinical problem with no current consensus. The purpose of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Surgical mesh infection (SMI) after abdominal wall hernia repair (AWHR) is a challenging and highly debated clinical problem with no current consensus. The purpose of this review was to analyze the literature about the use of negative pressure wound therapy (NPWT) in the management of the conservative treatment of SMI and report results about infected mesh salvage.
METHODS
A systematic review of EMBASE and PUBMED was performed describing the use of NPWT in patients with SMI following AWHR. Reviewed articles evaluating data about the association between clinical, demographic, analytic and surgical characteristics about SMI after AWHR were analyzed. The high heterogeneity of these studies did not allow a meta-analysis of outcomes.
RESULTS
The search strategy yielded 33 studies from PubMed, and 16 studies from EMBASE. NPWT was performed in 230 patients across 9 studies being achieved the mesh salvage in 196 (85.2%). Of these 230 cases, 46% were polypropylene (PPL), 9.9% polyester (PE), 16.8% polytetrafluoroethylene (PTFE), 4% biologic and 10.2% composite mesh (PPL and PTFE). Infected mesh location was onlay (43%), retromuscular (22%), preperitoneal (19%), intraperitoneal (10%) and between the oblique muscles (5%). The better option on salvageability with the use of NPWT was the combination of macroporous PPL mesh in an extraperitoneal position (19.2% onlay, 23.3% preperitoneal, 48.8% retromuscular).
CONCLUSION
NPWT is a sufficient approach to treat SMI following AWHR. In most cases, infected prostheses can be salvaged with this management. Further studies with a larger sample size are needed to confirm our analysis results.
Topics: Humans; Hernia, Ventral; Herniorrhaphy; Negative-Pressure Wound Therapy; Prostheses and Implants; Surgical Mesh
PubMed: 36802233
DOI: 10.1007/s00268-023-06943-4 -
Hernia : the Journal of Hernias and... Dec 2020Laparoscopic intraperitoneal onlay mesh in hernia repair can result in adhesions leading to intestinal obstruction and fistulation. The aim of this systematic review is... (Meta-Analysis)
Meta-Analysis
PURPOSE
Laparoscopic intraperitoneal onlay mesh in hernia repair can result in adhesions leading to intestinal obstruction and fistulation. The aim of this systematic review is to compare the effects of mesh coatings reducing the tissue-to-mesh adhesion in animal studies.
METHODS
Pubmed and Embase were systematically searched. Animal experiments comparing intraperitoneally placed meshes with coatings were eligible for inclusion. Only studies with comparable follow-up, measurements, and species were included for data pooling and subsequent meta-analysis.
RESULTS
A total of 131 articles met inclusion criteria, with four studies integrated into one comparison and five studies integrated into another comparison. Compared to uncoated polypropylene (PP) mesh, PP mesh coated with hyaluronic acid/carboxymethyl cellulose (HA/CMC) showed significantly reduced adhesion formation at follow-up of 4 weeks measured with adhesion score of extent (random effects model, mean difference,- 0.96, 95% CI - 1.32 to - 0.61, P < 0.001, I = 23%; fixed effects model, mean difference,- 0.94, 95% CI - 1.25 to - 0.63, P < 0.001, I = 23%). Compared to PP mesh, polyester mesh coated with collagen (PC mesh) showed no significant difference at follow-up of 4 weeks regarding percentage of adhesion-area on a mesh, using random effects model (mean difference - 11.69, 95% CI - 44.14 to 20.76, P = 0.48, I = 92%). However, this result differed using fixed effects model (mean difference - 25.55, 95% CI - 33.70 to - 7.40, P < 0.001, I = 92%).
CONCLUSION
HA/CMC coating reduces adhesion formation to PP mesh effectively at a follow-up of 4 weeks, while the anti-adhesive properties of PC mesh are inclusive comparing all study data.
Topics: Animals; Disease Models, Animal; Female; Herniorrhaphy; Surgical Mesh; Treatment Outcome
PubMed: 31659548
DOI: 10.1007/s10029-019-02071-y -
Archives of Dermatological Research Jun 2024Fast gut cutaneous sutures have become more prominent due to their low tissue reactivity, rapid absorption, and elimination of suture removal visits. It is not known how... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Fast gut cutaneous sutures have become more prominent due to their low tissue reactivity, rapid absorption, and elimination of suture removal visits. It is not known how fast gut sutures compare to other closure modalities.
METHODS
A comprehensive literature review was conducted to identify randomized controlled trials comparing fast gut sutures to alternative closure methods during dermatologic surgery. Data collected included patient and physician assessed cosmetic outcome as well as standardized complication rates.
RESULTS
Six studies were included in final analysis and reported on 208 patients. Fast gut sutures were associated with lower physician opinions of final scar when compared to polypropylene sutures (SMD 0.438; 95% CI 0.082 to 0.794). No differences existed between physician opinion of fast gut sutures and cyanoacrylate tissue adhesive (SMD - 0.024; 95% CI - 0.605 to 0.556). Complications with fast gut suture placement were rare, and included infection, dehiscence, and hematomas. Fast gut sutures were less likely to experience wound dehiscence than tissue adhesive (p = 0.01).
CONCLUSION
If no contraindications to polypropylene sutures exist, they may provide superior cosmetic outcomes compared to fast gut sutures. Further research is required to better quantify cosmetic outcomes and optimal use of fast gut sutures.
Topics: Humans; Sutures; Dermatologic Surgical Procedures; Suture Techniques; Tissue Adhesives; Polypropylenes; Cicatrix; Randomized Controlled Trials as Topic; Cyanoacrylates; Wound Healing
PubMed: 38850366
DOI: 10.1007/s00403-024-02973-7