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What's the Harm? - December 2015 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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the problems associated with permanent synthetic mesh, including chronic inflammation and foreign body reaction, stiffness and fibrosis, and mesh infection. Studies have shown that the risk of wound com- plications is unreasonably high when permanent synthetic mesh is placed in contaminated fields. Cavallaro et al., argued that biologic mesh should be used in contaminated fields because 50% to 90% of synthetic meshes placed in that setting required removal. "I'm an evidence man," says Dr. Snyder. "Except where there's already an infection, to me there's no compelling evidence that biolog- ics would be better or more useful than synthetics." Biosynthetics: a new class of hernia mesh Due to the moderate durability and substantial cost of biologics, mesh made of biodegradable polymers instead of animal or cadaver tissue is gaining in popularity. Biosynthetic or resorbable synthetic mesh has become more widely used for large ventral hernia repair and abdomi- nal wall reconstruction, says Bruce Ramshaw, MD, FACS, the co- director of Advanced Hernia Solutions and chairman and chief med- ical officer of Surgical Momentum. "Similar to the biologics, resorbable synthetic meshes are designed to provide mechanical strength as well as a temporary scaffold struc- ture for tissue ingrowth during the critical period of wound healing," says Dr. Ramshaw. "Unlike biologic mesh, resorbable synthetics have relatively predictable mechanical properties, including compliance, elasticity, strength and fracture, as well as rate of absorption and degradation." OSM E-mail doconnor@outpatientsurgery.net. 8 2 O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2 0 1 5

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