The Role of Biological Implants in the Repair and Prevention of Parastomal Hernia

Parastomal herniation is an often encountered consequence of stoma formation. Most parastomal hernias never require surgical intervention. Of the numerous procedures for the repair of parastomal hernias, the best outcomes have been obtained with the application of synthetic mesh. The potential for serious complications arising from synthetic mesh has prompted investigations of biological implants as an alternative. These grafts provide an acellular collagen scaffold into which host cells migrate, producing the appropriate native tissue. The experience with the biomaterials AlloDerm, Permacol, Surgisis Gold, and Veritas for parastomal hernia repair has yielded satisfactory results in small, nonrandomized, short-term studies and case reports. Similarly, limited audits suggest the promise of these bioprostheses in the prevention of parastomal hernias. However, in light of their expense, further inquiries are warranted before adopting biological implants as a routine substitute for synthetic mesh.