Biocompatibility of Biomaterials - Histological Aspects

Abstract

The history of surgical meshes is an outstanding example of the progress that has taken place in hernia surgery and the possible benefits for patients from the use of biomaterials in general. Whereas in the 1960s the introduction of polymer meshes was considered a revolutionary and unconventional step in hernia repair, modern hernia surgery would not be conceivable without the use of these special biomaterials. Finally, the era of laparoscopic surgery further increased the use of polymer meshes, representing a central prerequisite of this progressive surgical technique. Overall, hernia repair using polymer meshes achieves satisfying results in the majority of patients, with recurrence rates lower than 10% (Amid et al. 1992; Shulman et al. 1992). In particular, the repair of complicated or large incisional hernias mainly depends on the employment of meshes (Walker et al. 1976; Sugarbaker 1980; Imvrios et al. 1994). The effectiveness of the implants is based on their method of working either by mechanical closure of the defect (sublay technique) or the integration of the mesh into the artificial abdominal wall mainly by the induction of a strong scar tissue around the mesh fibres (Klosterhalfen et al. 1997).