Summary of findings 2. Nonabsorbable tacks compared to nonabsorbable sutures in primary ventral or incisional hernia repair.
| Nonabsorbable tacks compared to nonabsorbable sutures in primary ventral or incisional hernia repair | ||||||
| Patient or population: People with primary ventral or incisional hernia repair Setting: Hospital Intervention: Nonabsorbable tacks Comparison: Nonabsorbable sutures | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with nonabsorbable sutures | Risk with nonabsorbable tacks | |||||
| Recurrence (6 months) | 56 per 1000 | 56 per 1000 (4 to 822) | RR 1.00 (0.07 to 14.79) | 36 (1 RCT) | ⊕⊝⊝⊝a VERY LOW | ‐ |
| Early postoperative pain (VAS 0 ‐ 10, 1 week) | The mean pain was 0.00 | MD 0.56 lower (1.79 lower to 0.67 higher) |
‐ | 53 (1RCT) |
⊕⊝⊝⊝ VERY LOWb | ‐ |
| Chronic pain (VAS 0 ‐ 10, 6 to 12 months) | Not pooled because of heterogeneity | In both studies pain was higher using tacks Range of MD: 0/3 higher to 1.3 higher |
‐ | 89 (2 RCT) | ⊕⊝⊝⊝ VERY LOWc | ‐ |
| Health‐related quality of life | Not assessed in any study | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; MD; mean difference | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
aRated down by one level for risk of bias (performance bias) and by two levels for imprecision (optimal information size threshold not reached and 95% confidence intervals include appreciable benefit and appreciable harm). bRated down by two levels for risk of bias and by two levels for imprecision (optimal information size threshold not reached and 95% confidence intervals include appreciable benefit and appreciable harm). cRated down by two levels for risk of bias and by one level for inconsistency.