Synthetic Mesh: Making Educated Choices
The choice of mesh for hernia repair is a very complex issue. There are hundreds of options of mesh clinically available. Since hernia mesh has grown to become an approximately $1 Billion market, there are too many choices to know what would be best for which patient and what technique. Mesh is currently used based on surgeon preference less and less and based on hospital contracting more and more. However, mostly missing in the choice of mesh is the patient preference and the actual value provided to various patient groups and techniques. Measuring the value of the care provided and the value of devices and drugs used during the care process will be a necessary component of the shift from volume to value for health care in the twenty-first century. This chapter will present synthetic mesh options available for hernia repair and some perspectives about how to choose between these options.
KeywordsHernia mesh Polypropylene Polyester PTFE Clinical quality improvement (CQI) Absorbable synthetic mesh Shared-decision process Complexity Complex systems science Nonlinear dynamics
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