Progress of clinical application of biological patch in hernia and abdominal surgery

Abstract

At present, synthetic patch is widely used in hernia and abdominal wall surgery, which has achieved good outcomes. However, it is difficult to avoid some disadvantages of the synthetic patch, such as patch infection, chronic pain, intestinal adhesion and even intestinal fistula. Once the patch is infected, it needs to be removed. In addition, because the synthetic patch may increase the probability of surgical site infection, it is not recommended to be applied in the area where is a definite contamination or infection. Biological patch is developed for the defects of synthetic patch, which has the advantages of better infection resistance, histocompatibility and completely absorbability. Biological patches have been proved to be safe for herniorrhaphy in potentially contaminated or infected sites. It has been effectively used in ventral hernia and the reconstruction of the abdominal wall tumor, infection or trauma. However, at present, the level of evidence about biological patch was low, and the results of many studies associated with biological mesh were quite different. So it was difficult to get consensus on the application of biological patch. Therefore, it is still necessary to take a cautious attitude towards the clinical application of biological patch. We expect a prospective clinical study to further demonstrate the long-term efficacy of biological patches. This article briefly reviews the current status and progress of clinical application of biological patches. Key words: Ventral hernia; Abdominal defect; Biologic mesh; Herniorrhaphy; Outcome