The battle between biological and synthetic meshes in ventral hernia repair

Abstract

Introduction of meshes for reinforcement has revolutionized the results of abdominal wall reconstructive surgery. Patients, even with former hopeless abdominal wall conditions, can be offered a new life gained from these developments. There is though a constant introduction of new ‘‘tailored’’ mesh products on the market, suggested to be used in different clinical settings and in different positions in the abdominal wall, hopefully with the aim to improve the results even further. The huge problem is the lack of evidence on when, where or even ever a specific mesh is to be used. A hot discussion at the moment is the indication on when to use a synthetic or biological mesh (BM). The total numbers of meshes that are exposed to the surgeons are enormous. Another huge problem is that there are subgroups within each mesh group that act totally different form others making it impossible to recommend one or the other type in a specific patient. In this issue of hernia, a total of eleven papers have been gathered concentrating mainly on complicated hernia situations, the use of different techniques, and different meshes for ventral hernia repair (VHR). Below you will find different arguments on pros and cons on biologic and synthetic meshes referring to the actual literature and by commenting the papers presented in this issue of Hernia with the aim to balance the discussion. The concept of biologic meshes