About this Research Topic
Biological mesh has partially failed to meet the expectations of hernia surgeons. The non-synthetic nature of these products theoretically allows them to be more resistant to infection. However, their high cost, surgical site occurrences rates as high as 66%, and hernia recurrence rates of 50% during long-term follow-up have tempered the initial enthusiasm. Besides, biological prostheses are not free from the risk of infection.
Biosynthetic resorbable mesh was developed as a possible cost-effective alternative to synthetic and tissue-derived products. The findings in short-term follow-ups in animal experiments suggest this mesh might be safe for the prevention or treatment of abdominal wall defects in clean settings. So, scaffolds like P4HB polymer (Phasix™) or polyglycolide—trimethylene carbonate copolymer (Bio-A™) have yielded higher rates of bacterial clearance, with a more minimal effect on their burst strength because of the full resorption and reduced foreign body reaction.
The use of these types of mesh has shown a potential decrease in the hospital budget. The advantages, such as reabsorption after 12–18 months, the foreign body reaction reduction, high rates of bacterial clearance, and acceptable results in patients with risk factors and surgeries classified as Class II/III by the Centers for Disease Control (CDC), have led to wider indications for AWHR in contaminated fields. For this reason, it has been hypothesized that P4HB mesh might resist infection in contaminated or potentially contaminated fields (CDC Grade III/IV), especially when there is a high possibility of chronic mesh infection.
Moreover, there is no evidence that the absorbable nature of the mesh might not potentially create a predisposition to hernia recurrence following absorption.
The goal of this Research Topic is to study and describe the indications and results using these meshes in abdominal wall hernia repair, providing information to researchers interested in this field.
All article types are welcome with a focus on the themes of:
- Characteristics of these meshes
- Clinical indications in abdominal wall surgery
- Use in contaminated fields
- Use in prophylaxis of incisional hernia
- Complications of absorbable meshes
- Recurrence after surgery with biosynthetic meshes
Keywords: Biosynthetic, Absorbable Mesh, Abdominal Wall Surgery, Hernia, Prostheses
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