Biologic Prosthetic Materials for Hernia Repair: Non-Human
Biological prosthetics are useful when the surgeon is faced with a infected or contaminated wound but must cover a fascial defect. Their goal is to create a scaffold that will allow cells to attach but will not serve as a continuing source of infection. The disadvantage of these prosthetics is their lack of strength in effecting a long-term repair. Because of this, they are not routinely used in elective abdominal hernia repair and many surgeons have abandoned them and have opted for placing a Wittman patch with staged closure.
Surgisis – Cook, made from the submucosal of pig intestine, decellularization reduces risk of immune-mediated rejection, scar tissue encapsulation does not occur because of lack of collagen cross-linking.
Permacol – Tissue Science Laboratories, made from collagen harvested from pig dermis, can be used in infected site, cross-linked to improve durability and strength.
Bard CollaMend – Davol, Inc., made from acellular collagen from pig dermis, cross-linked fibers require rehydration before use, retains good elasticity.
FortaGen – Organogenesis, Inc, made from pig intestines, non-cross linked, not widely used.
Veritas Collagen Matrix – Synovis Surgical, Inc., made from cow pericardium (sac surrounding the heart), more commonly used to reinforce anastomotic staple lines (Peri strips) than hernia repair
SurgiMend – TEI Bioscience, made from fetal cow dermis, not cross-linked, requires rehydration, has extended shelf-life.
Tutumesh – Tutogen Medical, Inc., made from cow pericardium, susceptible to shrinkage, relatively non-inflammatory.
Copyright 2008 InsideSurgery.comÂ®. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.