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

Yang Hu; Wuliang Diao; Shiyi Wen; Julius K S K Kpegah; Zhenyang Xiao; Xuan Zhou; Jianda Zhou; Ping Li

doi:10.1007/s00266-024-03879-5

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

Aesthetic Plast Surg. 2024 Mar 4. doi: 10.1007/s00266-024-03879-5. Online ahead of print.

Authors

Yang Hu¹, Wuliang Diao¹, Shiyi Wen¹, Julius K S K Kpegah¹, Zhenyang Xiao¹, Xuan Zhou², Jianda Zhou³, Ping Li⁴

Affiliations

¹ Department of Plastic Surgery of Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, China.
² Center for Medical Research, The Second Xiangya Hospital of Central South University, Changsha, China.
³ Department of Plastic Surgery of Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, China. zhoujianda@csu.edu.cn.
⁴ Department of Plastic Surgery of Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, China. 993850347@qq.com.

PMID: 38438762
DOI: 10.1007/s00266-024-03879-5

Abstract

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 .

Keywords: Biological meshes; Complications; Implant-based breast reconstruction surgery; Synthetic meshes.