Surgical meshes: types, clinical applications, and associated complications

Surgical meshes have transformed the repair of hernias and pelvic organ prolapse, advancing from conventional suture methods, which demonstrated elevated recurrence rates, to efficient, tension-free prosthetic alternatives. This review examines the fabrication methods of various mesh types, their classification, and their efficacy in clinical environments. This discussion encompasses novel composites, biological scaffolds, and synthetic polymers such as polypropylene, polyester, and ePTFE. Most repairs utilize synthetic meshes, such as polypropylene, due to their efficacy and infrequent failure. However, they can result in significant long-term complications, including chronic inflammation, foreign body reactions, and pain. Lightweight, large-pore configurations and bioactive coatings are intended to enhance biocompatibility and facilitate tissue integration, thereby mitigating adverse effects. Biological and biosynthetic meshes, such as P4HB, demonstrate efficacy in contaminated environments; however, they are linked to higher recurrence rates and increased expenses. Surgical techniques, fixation methods, and individual patient variability significantly influence outcomes in the complex clinical environment. The field has experienced extensive regulatory oversight, particularly concerning transvaginal implants. This instance shows how important it is to have a lot of long-term data. Future trends point to a move toward smart, personalized solutions like 3D-printed scaffolds, drug-eluting meshes, and prosthetics with built-in biosensors. The best mesh must strike a balance between mechanical strength and biological compatibility. This is a goal that drives progress in both material science and surgery.