To help you make sense of the options, we asked some of the coun-
try's leading hernia experts about the different types and features of
mesh, and what you should consider when deciding which type to stock
in your facility.
• Mesh type. There are 3 basic types available: permanent synthetic,
biologic and hybrid.
Permanent synthetic is the most commonly used. It's been around
the longest and is the least costly option, ranging from $40 to $100
depending on your contract with the vendor. Dr. Blatnik says it's espe-
cially useful in outpatient facilities, "which are more commonly repair-
ing smaller inguinal and umbilical hernias, in comparison to much
more complex procedures done in a hospital setting." As its name
implies, permanent synthetic mesh doesn't absorb into the tissue. It's
there for life.
At the other cost extreme is biologic mesh, typically made of
porcine or bovine materials. This mesh completely absorbs into the
body over time. Dr. Blatnik says biologic mesh was once commonly
used to repair large incisional hernias, but it can cost thousands of
dollars just for a single piece. "It's fallen out of favor to a certain
extent due to cost constraints," he adds. "It's not the holy grail of
meshes that people initially thought it was going to be."
Hybrid mesh falls in between on the cost spectrum. Dr. Blatnik calls
these biosynthetic meshes, or absorbable synthetic meshes. He says
that while permanent synthetic is like a window screen, and biologic
like a solid sheet, hybrid is typically made from chemical polymers
and designed with a more mesh-like characteristic reminiscent of the
permanent synthetic surgeons know well.
Like biologic mesh, hybrid absorbs over time. "Biosynthetic is the
new, up-and-coming mesh because it alleviates the need for perma-
nent synthetic mesh," says Dr. Blatnik. "There's a lot of interest
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