Nickolas Byrge1, Mary C Mone1, Daniel Vargo2. 1. Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA. 2. Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA. Electronic address: daniel.vargo@hsc.utah.edu.
Abstract
BACKGROUND: A variety of biologic mesh is available for ventral hernia repair. Despite widely variable costs, there is no data comparing cost of material to clinical outcome. METHODS: Biologic mesh product change was examined. A prospective survey was done to determine appropriate biologic mesh utilization, followed by a retrospective chart review of those treated from Sept. 2012 to Aug. 2013 with Strattice™ and from Sept. 2013 to Aug. 2014 with Permacol™. Outcome variables included complications associated with each material, repair success, and cost difference over the two periods. RESULTS: 28 patients received Strattice™ and 41 Permacol™. There was no statistical difference in patient factors, hernia characteristics, length of stay, readmission rates or surgical site infections at 30 days. The charges were significantly higher for Strattice™ with the median cost $8940 compared to $1600 for Permacol™ (p < 0.001). Permacol™ use resulted in a savings if $181,320. CONCLUSIONS: Permacol™ use resulted in similar clinical outcomes with significant cost savings when compared to Strattice™. Biologic mesh choice should be driven by a combination of clinical outcomes and product cost.
BACKGROUND: A variety of biologic mesh is available for ventral hernia repair. Despite widely variable costs, there is no data comparing cost of material to clinical outcome. METHODS: Biologic mesh product change was examined. A prospective survey was done to determine appropriate biologic mesh utilization, followed by a retrospective chart review of those treated from Sept. 2012 to Aug. 2013 with Strattice™ and from Sept. 2013 to Aug. 2014 with Permacol™. Outcome variables included complications associated with each material, repair success, and cost difference over the two periods. RESULTS: 28 patients received Strattice™ and 41 Permacol™. There was no statistical difference in patient factors, hernia characteristics, length of stay, readmission rates or surgical site infections at 30 days. The charges were significantly higher for Strattice™ with the median cost $8940 compared to $1600 for Permacol™ (p < 0.001). Permacol™ use resulted in a savings if $181,320. CONCLUSIONS: Permacol™ use resulted in similar clinical outcomes with significant cost savings when compared to Strattice™. Biologic mesh choice should be driven by a combination of clinical outcomes and product cost.
Authors: Ruth Kaufmann; Friedrich-Eckart Isemer; Christoph W Strey; Johannes Jeekel; Johan F Lange; Guido Woeste Journal: Langenbecks Arch Surg Date: 2020-04-22 Impact factor: 3.445