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What Are the Benefits and Risks of Mesh in Hernia Repairs?

The mesh used for surgical hernia repairs can reduce the rate at which the repairs fail, but at the same time increase the risk of complications.
What Are the Benefits and Risks of Mesh in Hernia Repairs?
CC0 from https://pixabay.com/en/hospital-surgery-medical-health-721240/

When people need surgery to fix abdominal hernias, the surgeon often uses a piece of mesh to strengthen the hernia repairs. The investigators reviewed the records of all surgical hernia repairs in Denmark between January 1, 2007 and December 31, 2010. That included 3,242 patients who were followed up to the end of 2014.

How Much Does Mesh Help?

Surgical mesh is woven or knit of synthetic materials such as polypropylene. Using this patch material reduced the likelihood that the hernia would return within five years and require a second operation. Only 12.3 percent of those on whom mesh was used needed to go back to the operating room compared to 17.1 percent of those who did not get mesh.

But What About Problems with Mesh?

That good news is counterbalanced by a higher rate of complications in the surgeries using mesh. People receiving mesh had more bowel obstructions and perforation. They also were more likely to develop surgical site infections, late abdominal abscesses, fistulas, non-healing wounds and chronic abdominal pain following surgery. After five years, 5.6 percent of the people whose hernia repairs included mesh had experienced a significant complication in comparison to 0.8 percent of those operated on without mesh.

The authors conclude that “the benefits attributable to mesh are offset in part by mesh-related complications.”

JAMA, Oct. 18, 2016

This is not the first time that the safety of surgical mesh has been questioned. You can read an earlier report here.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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