This editor is compelled to add a comment.

It would be reasonable to contend that these novel, rather expensive biomaterials—with thus far unproven long-term results—should be employed only in selected cases, where and when conventional nonbiologic meshes (which are less expensive and of proven long-term durability and results) are contraindicated. A classic situation in which a bio-patch would be a preferable option is the contaminated or infected abdominal wall defect of whatever etiology. Thus, it is difficult to understand why the authors of this article decided to use the patch made of porcine acellular dermis in patients with uncontaminated chronic ventral hernias amenable to conventional repair with well proven synthetic materials. Clearly, no data are available to prove that biologic prostheses are strong enough to bridge abdominal wall defects in the long term. Cross-linking of such materials increases fibroblast encapsulation and the resistance of the implant to degradation but decreases the rate of its cellular infiltration. However, the optimum cross-linking pattern and density to balance the durability of the biomaterial with cellular ingrowth and remodeling is unclear because of the lack of long-term clinical data [1].

We have to resist pressures from the aggressive industry that wants us to rush and implant experimental materials into human tissues for marginal indications. Remember the Kugel Patch? It was a wunderherniaprosthesis—until its recent recall [http://www.medscape.com/viewarticle/529032].