Biologic prosthetic materials for hernia repairs

Herniorrhaphy continues to be one of the most commonly performed operations worldwide. As the literature shows, there is a clear advantage to tension-free mesh reinforcement versus primary suture repair alone in most settings. The choice of medical implant is based on many factors, including type and location of hernia, host environment, efficacy with product utilization, and total cost. The use of prosthetic implants has evolved over the years from "first-generation" synthetic materials to "third-generation" biologic grafts. In this review, we report on various biologic materials used in the repair of ventral, inguinal, and hiatal hernias. Despite an ever-expanding selection of products, there is currently no consensus on when or how to use them, and no long-term data exist regarding the effect of implantation. The goal of this study is to highlight the current indications for bioprosthetic materials used in hernia repair, as well as the reported short- and long-term effects of implantation.