A Polymer-Biologic Hybrid Hernia Construct: Review of Data and Early Experiences

Abstract

Surgical mesh reinforcement of the human abdominal wall has been found to reduce the chance of recurrence in hernia repairs. While traditionally polymer meshes have been used in hernia repair, alternative mesh options have been engineered to prevent the inflammatory foreign body response invoked by polymers. A reinforced tissue matrix (RTM) mesh has been developed by embedding a polymer within a decellularized extracellular matrix. This combination has been attributed to the recruitment of host cells, a pro-healing response, and attenuation of the foreign body response. This has been observed to lead to the regeneration of functional tissue within the repair site that is reinforced by the polymer to offload abdominal pressures over time. This manuscript presents the review of OviTex, an RTM, in several types of hernia repair. The authors have found that the use of RTM in hernia repair is effective in preventing foreign body response, promoting wound healing, and providing reinforcement to lower the risk of hernia recurrence.

Definitive Closure Using an Ovine Reinforced Tissue Matrix in Contaminated Penetrating Abdominal Trauma

“…The use of surgical mesh is common in hernia repair. While biological meshes are routinely used for contaminated fields, the use of reinforced meshes may be an attractive alternative [ 8 ]. In our series, we demonstrated favorable outcomes with the use of an ovine RTM for the management of patients with complex, grossly contaminated, open thoraco-abdominal trauma.…”

Further structural characterization of ovine forestomach matrix and multi-layered extracellular matrix composites for soft tissue repair

“… 11 The kinetics of cell infiltration can be increased via engineered perforations to the dECM, enabling cells to more rapidly absorb into, and migrate through the graft, a feature that has been shown clinically in soft tissue and abdominal wall reconstructions. 11 , 19 , 62 The interlocking process introduced open pores that transect the OFM layers increasing the effective surface area of the device. Additionally, the interlocking process and the resultant approximation of opposing OFM layers form channels or openings between layers that further enable the lateral spread of cells.…”

Novel Material Optimization Strategies for Developing Upgraded Abdominal Meshes

“…Abdominal wall hernias are common defects caused by the weakening and loss of continuity of the fasciae and/or muscles with the protrusion of visceral organs, representing an important source of disability and morbidity in patients [ 1 , 2 , 3 , 4 ]. More than 20 million hernias are operated annually around the globe, with most surgical procedures imposing the need for mesh implantation [ 5 , 6 , 7 ].…”

“…Abdominal meshes were introduced to improve traditional suturing, which tends to bring excessive tension in the affected area, high recurrence rates, and increased pain [ 1 , 3 ]. The advances in the interconnected fields of health services, medical technology, and material sciences have led to the fabrication of numerous hernia repair meshes.…”