Evaluation of various prosthetic materials and newer meshes for hernia repairs

The use of prosthesis has become essential for repair of all hernias since the recurrence rates are consistently lower when they are used. To fulfill this requirement, a variety of newer meshes have been engineered. An ideal prosthesis should be strong, pliable, non-allergenic, inert, non-biodegradable, non-carcinogenic and should stimulate adequate fibroblastic activity for optimum incorporation into the tissues. Prosthesis used for hernia repairs can be non-absorbable, composite (combination of absorbable and non-absorbable fibres) or with an absorbable or a non-absorbable barrier. Surgeons should acquire sufficient knowledge of different types of prosthesis so as to select an appropriate one for a given case. Non-absorbable or composite mesh is recommended for hernia repair where it will not come in contact with the bowel. Prosthesis with a barrier only should be used for intra-abdominal placement to prevent bowel adhesions since it is increasingly difficult to defend the use of a biomaterial that has no adhesion barriers. This review highlghts all these different types of meshes and their appropriate selection for a given hernia repair. Selection of the optimum size and its proper fixation is mandaory. Complications can be avoided or minimized with proper selection of mesh for a given case and by performing the surgery with a meticulous technique.