The impact of conflict of interest in abdominal wall reconstruction with acellular dermal matrix

Brent R. De George, Michael C. Holland, David B. Drake

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Introduction: Conflict of interest (COI) and disclosure of financial relationships have received increased attention recently owing inpart to the passageof the Physician Payments Sunshine Act, which requires manufacturers of drugs, medical devices, and biological to record payments to physicians and health care systems. The impact of financial relationships with industry sponsorship and COI reporting on surgical outcomes of abdominal wall reconstruction with acellular dermal matrices (ADMs) has not been previously explored. Methods: A systematic review of the literature for studies that evaluated surgical outcomes in abdominalwall reconstruction using ADM was conducted. The level of evidence of these studies was evaluated; and data concerning the typeof industry, government, or national society sponsorship, primary outcome, complications, and statistical results were collected. The overall favorability of the study with respect to ADM use was systematically assessed. Comparisons between type of sponsorship and significant results were analyzed using the Pearson X2 test. Results: A total of 204 studies were identified, of which 124 fulfilled our inclusion criteria. Sixty-four (52%) studies had a disclosure statement present. Conflict of interest was reported in 39 (61%) of these studies. Taken collectively, studies that report no COI are more likely to be unfunded (P < 0.001). Studies with a reported COI are more likely to reporta favorable outcome with respect to infection (P < 0.01), wound complications (P < 0.01), and overall morbidity (P < 0.07) and mortality (P < 0.05). Conclusions: Industry sponsorship and COI are common in abdominal wall reconstruction studies with ADM. Studies authored by groups disclosing an industry conflict that report clinical outcomes are significantly associated with reporting lower postoperative complications, and consequently describing positive research findings.

Original languageEnglish
Pages (from-to)242-247
Number of pages6
JournalAnnals of Plastic Surgery
Issue number2
StatePublished - 2015

Bibliographical note

Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


  • Abdominal wall
  • Acellular dermal matrix
  • Bioprosthetic mesh
  • Conflict of interest

ASJC Scopus subject areas

  • Surgery


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