Synthetic and Biological Graft Materials: Biological Concepts

Graft or “mesh” implant materials continue to be used in a variety of surgical applications, including abdominal hernia repairs, suburethral slings, and female pelvic reconstructive surgery. The concern associated using autologous tissue for reconstructive surgery is that this tissue may be intrinsically weak and not suitable to repair fascial defects. Synthetic and biological mesh products have been developed to eliminate the need to rely on existing weak fascia or muscles and provide a more robust repair. The effect on wound healing depends on the type of mesh material as well as the anatomic site for implantation. While the perfect mesh material does not yet exist, the available products offer both benefits and risks with respect to the wound healing process while striving to maintain the necessary characteristics for tissue integrity. The objective of this review is to describe the biomechanical properties of commonly used mesh materials and the available evidence regarding their effects on wound healing.