Biologic and Absorbable Prosthetic: When, Why, and Where Are We Going

  • Michael R. Arnold
  • Angela M. Kao
  • Vedra A. AugensteinEmail author


Although synthetic mesh has dramatically reduced recurrence, its use in contaminated surgical fields and high-risk patients is a heavily debated topic. Deciding which type of mesh to use is a choice surgeons make commonly despite no existent guidelines. Biologic meshes emerged in the late 1990s with a rapid popularity fueled largely by the demand for an appropriate substitute in these complex cases. However, high cost and questions regarding hernia recurrence tempered the initial enthusiasm. Absorbable synthetic meshes were developed as a potentially more cost-effective alternative to synthetic and tissue-derived products, and their use in temporary abdominal closure was first described by Levasseur et al. in 1979 (Chirurgie 105:577–81, 1979). Herein, we review the current use of biologic and absorbable synthetic meshes for hernia repair.


Tissue reinforcement Hernia repair Synthetic mesh Biologic meshes Strattice XenMatrix FlexHD Permacol Absorbable synthetic mesh Hybrid mesh 



Dr. Augenstein has previously been awarded honoraria, speaking fees, surgical research funding, and education grants from W.L. Gore and Associates, Ethicon, and LifeCell Inc. All other authors confirm they have no financial and personal relationships that could potentially and inappropriately influence this work or its conclusions.


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Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2019

Authors and Affiliations

  • Michael R. Arnold
    • 1
  • Angela M. Kao
    • 1
  • Vedra A. Augenstein
    • 1
    Email author
  1. 1.Division of Gastrointestinal and Minimally Invasive Surgery, Department of SurgeryCarolinas Medical CenterCharlotteUSA

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