Technology of Prosthetic Material

Prosthetic material to repair a hernia is indicated for large defects, attenuated muscle, or tension avoidance on a repair. Biological, absorbable, and permanent material can be used to repair a hernia. Absorbable substances such as Dexon (Davis & Geck, Wayne, NJ) and Vicryl (Ethicon, Inc, Somerville, NJ) are useful in infected areas but have a high recurrence rate. Nonabsorbable material such as polyethylene, polypropylene, and polytetrafluoroethylene (PTFE) are the most commonly used materials for mesh repair of a hernia. The properties of these meshes are determined not only by their composition but also by the size of the fibrils and interstices. Marlex (Bard Vascular, Billerica, MA) has a thicker fibril diameter and large interstices that allow ingrowth of surrounding material but has some stiffness in handling. PTFE has small fibrils and interstices that result in less ingrowth of tissue but ease in handling. Prolene (Ethicon, Somerville, NJ) has intermediate size fibrils and interstices and moderate ingrowth of tissue and ease of handling.