Cook Medical
Biologics in Hernia Repair - The Cook Surgisis Biodesign
The role of Natural Biomaterials in Hernia repair is poorly understood by many trainees, and the benefits of remodelling in repairs are not well taught or explained. The article below (download from bottom of the page) helps to dispell some of the myths surrounding biomaterials. This information is useful for those approaching exams and looking to justify the uses and methods of repair.
"Hernia repairs buttressed by mesh are considered by most surgeons to be preferable to repairs made by suture alone particularly in terms of preventing recurrences.
The perfect mesh, however, has proved elusive. Ideally, the material should be strong, chemically inert, easy to produce in the sizes and shapes needed, sterilizable, hypoallergenic, resistant to the tissue’s fluids, and easily accepted by the host. Tension-free hernia repair has come a long way since surgeons started experimenting with available materials. In the 1940s, patients with a reinforced hernia repair walked away with mesh of steel. Plastic prosthetics debuted in the late 1950s. Pioneered by Francis C. Usher, in 1958, the first generation of Marlex mesh was made of polyethylene.
It provided the strength and inertness required of a suitable biomaterial, but could not be easily sterilized and thus proved to be unsatisfactory. In 1962, polypropylene was developed. This material not only provided all the advantages of polyethylene but also permitted sterilization by autoclaving. Since then, polypropylene mesh has proved to be the most suitable synthetic mesh for the
repair of groin hernias. Biologic grafts came onto the scene only within the last decade.
Permacol® and AlloDerm® were two of the original biologic grafts, along with Surgisis® Biodesign™, an advanced tissue repair graft that combines the best attributes of biologic grafts and synthetic mesh. Both Permacol and Surgisis Biodesign are FDA-cleared products, and since their debut, a proliferation of other biologic grafts have become available. Some of these other biologic grafts, specifically those of human origin, are classified as banked human tissue and have not been subject to FDA regulations typically required of medical devices....."
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