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Single-Institution Financial Analysis of Biologic Versus Synthetic Mesh Hernia Repair

A Retrospective Analysis of Patients Readmitted for Hernia Repair

Otake, Leo R. MD, PhD; Satterwhite, Thomas MD; Echo, Anthony MD; Chiou, Grace MD; Lee, Gordon K. MD

doi: 10.1097/SAP.0b013e31828a0c5e
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The advent and proliferation of commercially available biologic mesh material has expanded the repertoire of hernia repair materials available to the surgeon. Given the higher initial cost of these mesh materials relative to synthetic materials such as polypropylene, there has been debate regarding the purported benefit of the use of biologic mesh. This study is a single-institution review of complex hernia repairs using both biologic and synthetic mesh materials. The patients included in the analyses were admitted to the institution at least twice for management of hernia; this permitted specific evaluation of a given diagnosis, hernia, in the same patient, but at different points in time. In a subset of patients, hernia repair was performed upon the second admission with conversion from biologic or synthetic mesh, which had been placed at the initial repair. The objective of this study was to evaluate the financial implications of mesh choice. Specific parameters reviewed included type of mesh used, total costs of hospitalization, direct cost associated with the hernia repair, total collections, and percentage of collections relative to total charges. Through such analysis, our aim was to determine whether there were any variances in revenue and costs associated with the application of either mesh material or the associated clinical scenarios.

From the Division of Plastic and Reconstructive Surgery, Department of General Surgery, Stanford University Medical Center, Stanford, CA.

Received December 12, 2012, and accepted for publication, after revision, January 26, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Gordon K. Lee, MD, 770 Welch Rd, Suite 400, Division of Plastic Surgery, Stanford University Medical Center, Palo Alto, CA 94304. E-mail: glee@stanford.edu.

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