The Role of Bioactive Prosthetic Material for the Treatment of Sports Hernias

Electrospun P(LLA-CL) Nanoscale Fibrinogen Patch vs Porcine Small Intestine Submucosa Graft Repair of Inguinal Hernia in Adults: A Randomized, Single-Blind, Controlled, Multicenter, Noninferiority Trial

“…According to a published study, the recurrence rate of SIS patches (control group) was 4.9%; 17 therefore, we used 5% as the established recurrence rate. We assumed that the recurrence rate of the experimental group was comparable to that of the control group.…”

“…Clinical studies have shown that the recurrence rate using porcine SIS is 4.9%, 12 The incidence and degree of chronic pain after surgery were significantly lower than in those patients using synthetic permanent meshes. 13,17 However, because the product is derived from porcine small intestine, it requires the artificial separation of the mucous layer, muscular layer, and outer membrane, as well as decellularization by adopted physical methods (such as multiple freeze-thaws or application of supercritical fluid) or chemical methods (such as SDS or Triton-X-100 detergent, alkaline and acidic solutions, or enzyme applications), which is time consuming (several days to weeks) and labor intensive. 14,20 In addition, some heterogeneous cell debris may be left behind, including DNA and a1,3-galactose antigen debris, which increase the risk of immunoreactions.…”

“…16 Among the various biological surgery grafts, Biodesign Surgisis (Cook Biotech) is the most successful biologic graft developed to date. 12,13,17 It is an acellular matrix derived from porcine SIS without fixation of chemical cross-linking agents. This graft is mainly composed of type I or type III, and a small amount of type V or type VI, collagen fibers.…”

Absorbable Meshes in Inguinal Hernia Surgery: A Systematic Review and Meta-Analysis

“…19 The total recurrence rate for absorbable meshes was 5.6%. 12,[20][21][22][23][24][25][27][28][29][30] with a median follow-up of 13 months (range 6-60 months); 2.8 % in the first postoperative year 12,20,21,26,[28][29][30] and 8.1% 2-5 years postoperatively. [22][23][24][25]27 Only considering the RCTs, [20][21][22][23] absorbable meshes had a recurrence rate of 2.0% compared with 1.3% for the permanent meshes; follow-up was median 18 months (range 12-36 months).…”

“…For the same studies, 65% of the primary hernias in total were lateral hernias and only 29% medial. Furthermore, seven studies described all primary hernias repaired in the absorbable group 12,20,21,24,25,27,30 . Of these, 21.6% (16/74) of the primary medial hernias and 1.1% (2/178) of the primary lateral hernias recurred (P < .0005, chi-squared test).…”