The Usage of Mesh and Relevant Prognosis in Implant Breast Reconstruction Surgery: A Meta-analysis

• Published in: Aesthetic plastic surgery Vol. 48; no. 17; pp. 3386 - 3399
• Main Authors: Hu, Yang, Diao, Wuliang, Wen, Shiyi, Kpegah, Julius K. S. K., Xiao, Zhenyang, Zhou, Xuan, Zhou, Jianda, Li, Ping
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2024; Springer Nature B.V
• Subjects: Breast Implantation - adverse effects; Breast Implantation - instrumentation; Breast Implantation - methods; Breast Implants - adverse effects; Breast Neoplasms - surgery; Female; Humans; Mastectomy - methods; Medicine; Medicine & Public Health; Original Articles; Otorhinolaryngology; Plastic Surgery; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prognosis; Risk Assessment; Surgery; Surgical mesh; Surgical Mesh - adverse effects; Well being; Biological meshes; Implant-based breast reconstruction surgery; Complications; Synthetic meshes
• ISSN: 0364-216X; 1432-5241; 1432-5241
• DOI: 10.1007/s00266-024-03879-5

Background Although mesh-based implant breast reconstruction surgery is emerging as the primary surgical procedure for breast reconstruction, mesh use remains controversial in implant breast reconstruction surgery, especially in terms of how to select the ideal mesh. Our aim is to elaborate relevant prognosis in the mesh-based implant breast reconstruction surgery. Methods Relevant studies were identified from PubMed, Web of Science, EMBASE, and Cochrane library searches. Extracted data included study type, basic characteristics, mesh information, complications, etc. We analyzed the included cohort studies and randomized controlled trials that reported mesh-related implant breast reconstruction complications and breast quality scale scores. Results A total of 32 studies including 7475 subjects were included. The results showed that the overall complication rate was 2.07 times higher in the biological mesh group than in the synthetic mesh group (risk ratio [RR]: 2.07, 95% CI 1.14–3.78). The risk of seroma was 4.50 times higher in the biological mesh group than in the synthetic mesh group (RR: 4.50, 95% CI 2.27–8.95). In terms of comparing breast quality scale scores, the mesh group had scores that were 1.49 (95% CI 0.19–2.78) higher than the non-mesh group for “physical well-being” and 2.05 (95% CI 0.08–4.02) higher for “sexual well-being.” Conclusions Our study found that the risk of total complications was higher with biological mesh than with synthetic mesh in implant breast reconstruction surgery. Based on short-term cost, healthcare burden, and healthcare benefits, synthetic meshes are superior to biological meshes. 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 .