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Clin Colon Rectal Surg 2014; 27(04): 134-139
DOI: 10.1055/s-0034-1394087
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Biomaterials: So Many Choices, So Little Time. What Are the Differences?

John D. Hunter III
1   Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
,
Jamie A. Cannon
1   Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
› Author Affiliations
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Publication History

Publication Date:
10 November 2014 (online)

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Abstract

The use of biologic mesh has increased greatly in recent years in response to the need for a solution in managing contaminated hernias. Multiple different meshes are commercially available, and are derived from a variety of sources, including human dermis as well as animal sources. For a mesh to be effective, it must be resistant to infection, have adequate tensile strength for hernia repair, and be well tolerated by the host. To achieve this end, biologic meshes go through an intense processing that varies from one product to the next. In this article, the authors review the types of mesh available, how they are processed, and examine these characteristics in terms of their strengths and weaknesses in application to surgical technique.

Keywords

biologic mesh - cross-linking - xenograft - ventral hernia
 

  • References

  • 1 Butler CE. The role of bioprosthetics in abdominal wall reconstruction. Clin Plast Surg 2006; 33 (2) 199-211 , v–vi
    CrossrefPubMedSearch in Google Scholar
  • 2 Sandor M, Xu H, Connor J , et al. Host response to implanted porcine-derived biologic materials in a primate model of abdominal wall repair. Tissue Eng Part A 2008; 14 (12) 2021-2031
    CrossrefPubMedSearch in Google Scholar
  • 3 Gilbert TW, Sellaro TL, Badylak SF. Decellularization of tissues and organs. Biomaterials 2006; 27 (19) 3675-3683
    PubMedSearch in Google Scholar
  • 4 Keane TJ, Londono R, Turner NJ, Badylak SF. Consequences of ineffective decellularization of biologic scaffolds on the host response. Biomaterials 2012; 33 (6) 1771-1781
    CrossrefPubMedSearch in Google Scholar
  • 5 Badylak SF. Decellularized allogeneic and xenogeneic tissue as a bioscaffold for regenerative medicine: factors that influence the host response. Ann Biomed Eng 2014; 42 (7) 1517-1527
    CrossrefPubMedSearch in Google Scholar
  • 6 Crapo PM, Gilbert TW, Badylak SF. An overview of tissue and whole organ decellularization processes. Biomaterials 2011; 32 (12) 3233-3243
    CrossrefPubMedSearch in Google Scholar
  • 7 Gilbert TW, Freund JM, Badylak SF. Quantification of DNA in biologic scaffold materials. J Surg Res 2009; 152 (1) 135-139
    CrossrefPubMedSearch in Google Scholar
  • 8 Cooper DK. Xenoantigens and xenoantibodies. Xenotransplantation 1998; 5 (1) 6-17
    CrossrefPubMedSearch in Google Scholar
  • 9 McPherson TB, Liang H, Record RD, Badylak SF. Galalpha(1,3)Gal epitope in porcine small intestinal submucosa. Tissue Eng 2000; 6 (3) 233-239
    CrossrefPubMedSearch in Google Scholar
  • 10 Daly KA, Stewart-Akers AM, Hara H , et al. Effect of the alphaGal epitope on the response to small intestinal submucosa extracellular matrix in a nonhuman primate model. Tissue Eng Part A 2009; 15 (12) 3877-3888
    CrossrefPubMedSearch in Google Scholar
  • 11 Rosen MJ. Biologic mesh choices for surgical repair. In: Atlas of Abdominal Wall Reconstruction. Chapter 18. Philadelphia, PA: Elsevier Saunders; 2012: 316-321
    Search in Google Scholar
  • 12 Badylak S, Kokini K, Tullius B, Whitson B. Strength over time of a resorbable bioscaffold for body wall repair in a dog model. J Surg Res 2001; 99 (2) 282-287
    CrossrefPubMedSearch in Google Scholar
  • 13 Poulose BK, Scholz S, Moore DE , et al. Physiologic properties of small intestine submucosa. J Surg Res 2005; 123 (2) 262-267
    CrossrefPubMedSearch in Google Scholar
  • 14 D'Ambra L, Berti S, Feleppa C, Magistrelli P, Bonfante P, Falco E. Use of bovine pericardium graft for abdominal wall reconstruction in contaminated fields. World J Gastrointest Surg 2012; 4 (7) 171-176
    CrossrefPubMedSearch in Google Scholar
  • 15 Khor E. Methods for the treatment of collagenous tissues for bioprostheses. Biomaterials 1997; 18 (2) 95-105
    CrossrefPubMedSearch in Google Scholar
  • 16 Butler CE, Burns NK, Campbell KT, Mathur AB, Jaffari MV, Rios CN. Comparison of cross-linked and non-cross-linked porcine acellular dermal matrices for ventral hernia repair. J Am Coll Surg 2010; 211 (3) 368-376
    CrossrefPubMedSearch in Google Scholar
  • 17 Deeken CR, Melman L, Jenkins ED, Greco SC, Frisella MM, Matthews BD. Histologic and biomechanical evaluation of crosslinked and non-crosslinked biologic meshes in a porcine model of ventral incisional hernia repair. J Am Coll Surg 2011; 212 (5) 880-888
    CrossrefPubMedSearch in Google Scholar
  • 18 Harth KC, Blatnik JA, Anderson JM, Jacobs MR, Zeinali F, Rosen MJ. Effect of surgical wound classification on biologic graft performance in complex hernia repair: an experimental study. Surgery 2013; 153 (4) 481-492
    CrossrefPubMedSearch in Google Scholar
  • 19 Bellows CF, Wheatley B, Moroz K, Rosales S, Morici LA. Histologic and biomechanical evaluation of biologic meshes following colonization with Pseudomonas aeruginosa. J Surg Res 2012; 175 (1) e35-e42
    CrossrefPubMedSearch in Google Scholar
  • 20 Sbitany H, Kwon E, Chern H, Finlayson E, Varma MG, Hansen SL. Outcomes analysis of biologic mesh use for abdominal wall reconstruction in clean-contaminated and contaminated ventral hernia repair. Ann Plast Surg 2013; [e-pub ahead of print]
    PubMedSearch in Google Scholar
  • 21 Rosen MJ, Krpata DM, Ermlich B, Blatnik JA. A 5-year clinical experience with single-staged repairs of infected and contaminated abdominal wall defects utilizing biologic mesh. Ann Surg 2013; 257 (6) 991-996
    CrossrefPubMedSearch in Google Scholar
  • 22 http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/default.htm
    PubMed

    • Suggested Readings

    • 1 Novitsky YW, Rosen MJ. The biology of biologics: basic science and clinical concepts. Plast Reconstr Surg 2012; 130 (5, Suppl 2) 9S-17S
      CrossrefPubMedSearch in Google Scholar
    • 2 Ramshaw B, Bachman S. Surgical materials for ventral hernia repair: biologic mesh Part 2 of 3. Gen Surg News 2007; 10
      PubMedSearch in Google Scholar
    • 3 Bellows CF, Alder A, Helton WS. Abdominal wall reconstruction using biological tissue grafts: present status and future opportunities. Expert Rev Med Devices 2006; 3 (5) 657-675
      CrossrefPubMedSearch in Google Scholar