often will want to use pricey biologics — made from human or animal
tissue — when there's a high risk of infection, since they can encour-
age growth of healthy tissue and potentially reduce bioburden con-
tamination. But biosynthetic or absorbable synthetic meshes could
give your docs the benefits of biologics at a synthetic's price tag.
Absorbable synthetic options are around half the cost of true biologic
meshes, and the non-absorbable meshes are even less, says Dr.
Kercher.
Absorbable synthetic meshes are made from synthetic materials that
gradually break down over time. They mimic biologic mesh and usually
feature a fully reabsorbable monofilament scaffold design that lets new
tissue grow and strengthen the hernia repair. Because they help rein-
force the repair without leaving a lasting foreign object in the body, they
tend to work best in cases where there is bacterial burden near or with-
in the surgical site, says Dr. Nguyen. "You use absorbable mesh in situa-
tions where you're concerned that if the mesh does not break down, it
can become a source of infection," he says.
While the mesh may help prevent infection, scientific evidence back-
ing up the claims is limited. There's also a chance of recurrence, since
the mesh will eventually disappear. "With an absorbable mesh, we can
achieve the goals of hernia repair, which is to put some type of mesh
in there to keep the abdominal wall closed," says Dr. Kercher. "The
downside is, if you have a mesh that's going to go away over 4 to 18
months, then what you have to rely on is that the patient's body will
form scar tissue to minimize the chance of recurrence."
2. Hybrids offer best of both worlds
For surgeons who want to maintain some of the benefits of
absorbable mesh, but want permanent reinforcement for the hernia
repair, hybrid meshes — made from part biosynthetic/biologic, part
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