A Cost-Utility Assessment of Mesh Selection in Clean-Contaminated Ventral Hernia Repair

Plastic and Reconstructive Surgery
John P FischerStephen J Kovach

Abstract

Mesh reinforcement can reduce hernia recurrence, but mesh selection is poorly understood, particularly in contaminated defects. Acellular dermal matrix has enabled single-stage ventral hernia repair in clean-contaminated wounds but can be associated with higher complications and cost compared with synthetic mesh. This study evaluated the cost-utility of synthetic mesh and acellular dermal matrix for clean-contaminated ventral hernia repairs. A systematic review of articles comparing outcomes for synthetic and acellular dermal matrix repairs identified 14 ventral hernia repair-specific health states. Quality-adjusted life years were determined through Web-based visual analog scale survey of 300 nationally representative individuals. Overall expected cost and quality-adjusted life-years for ventral hernia repair were assessed using a Monte Carlo simulation with sensitivity analyses. Synthetic mesh reinforcement had an expected cost of $15,776 and quality-adjusted life-year value gained of 21.03. Biological mesh had an expected cost of $23,844 and quality-adjusted life-year value gained of 20.94. When referencing a common baseline (do nothing), acellular dermal matrix (incremental cost-effectiveness ratio, 3378 ($/quality-adjusted...Continue Reading

References

Oct 9, 1996·JAMA : the Journal of the American Medical Association·L B RussellM C Weinstein
Oct 16, 1996·JAMA : the Journal of the American Medical Association·M C WeinsteinL B Russell
Oct 23, 1996·JAMA : the Journal of the American Medical Association·J E SiegelM R Gold
Aug 10, 2000·The New England Journal of Medicine·R W LuijendijkJ Jeekel
Dec 24, 2002·Annals of Surgery·David R FlumThomas Koepsell
Aug 9, 2003·Diseases of the Colon and Rectum·Daniel J GeislerPhilip D Kondylis
Jul 18, 2006·Current Surgery·David M ParkerJames H North
Jul 10, 2007·American Journal of Surgery·Charles F BellowsSamir S Awad
May 10, 2008·American Journal of Surgery·Jeffrey BlatnikMichael Rosen
Oct 20, 2009·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·Rachel CaskeyG Caleb Alexander
Nov 17, 2009·Plastic and Reconstructive Surgery·Sandra V Kotsis, Kevin C Chung
Nov 18, 2009·Archives of Surgery·Jason H KoGregory A Dumanian
Feb 2, 2010·Journal of the American College of Surgeons·Radovan VeljkovicAlexander Stojadinovic
Aug 18, 2010·Archives of Surgery·Dimitrios XourafasAli Tavakkolizadeh
Aug 28, 2010·The Journal of Pain : Official Journal of the American Pain Society·Catherine B JohannesRobert H Dworkin
Dec 29, 2010·Hernia : the Journal of Hernias and Abdominal Wall Surgery·B C ShahD Oleynikov
Jul 12, 2011·American Journal of Surgery·Mary T HawnCatherine C Vick
Sep 10, 2011·Hernia : the Journal of Hernias and Abdominal Wall Surgery·B K PouloseM D Holzman
May 15, 2012·American Journal of Surgery·Gabrielle H van RamshorstJohan F Lange
Jul 18, 2012·Annals of Surgery·Eric J CulbertsonMichael G Franz
Dec 28, 2012·Hernia : the Journal of Hernias and Abdominal Wall Surgery·K C HarthM J Rosen
Mar 14, 2013·The Laryngoscope·Luke Rudmik, Michael Drummond
Sep 21, 2013·Journal of the American College of Surgeons·Alfredo M CarbonellMichael J Rosen
Oct 3, 2013·Journal of the American College of Surgeons·Justin H BoothCharles E Butler
Oct 9, 2013·World Journal of Surgery·Ali DarehzereshkiNamir Katkhouda
Dec 20, 2013·Plastic and Reconstructive Surgery·Erika Davis SearsKevin C Chung
Jan 1, 2014·Plastic and Reconstructive Surgery·Abhishek ChatterjeeJoseph M Rosen
Aug 2, 2014·Hernia : the Journal of Hernias and Abdominal Wall Surgery·William C ColeLisa M Pierce

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Citations

Jan 24, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Yohann RenardReza Kianmanesh
Jan 14, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S J ZolinD M Krpata
Apr 26, 2020·Plastic and Reconstructive Surgery·Steven J SchneebergerJeffrey E Janis
Dec 8, 2017·Langenbeck's Archives of Surgery·A KoscielnyP Lingohr
Jul 2, 2018·Hernia : the Journal of Hernias and Abdominal Wall Surgery·B J SunR S Nazerali
Jan 12, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·F Ruiz-JasbonM-L Ivarsson
Nov 25, 2020·Tissue Engineering and Regenerative Medicine·Julio C SánchezJuliana Buitrago
Jan 20, 2021·Hernia : the Journal of Hernias and Abdominal Wall Surgery·M P MorrisJ P Fischer
Jan 20, 2020·Journal of the American College of Surgeons·Jeremy WarrenWilliam S Cobb
Apr 11, 2021·The Journal of Surgical Research·Adrienne N ChristopherJohn P Fischer
Apr 29, 2021·Hernia : the Journal of Hernias and Abdominal Wall Surgery·A N ChristopherJ P Fischer
Nov 11, 2021·Plastic and Reconstructive Surgery·Adrienne N ChristopherJohn P Fischer

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