Update on the utilization of grafts in pelvic reconstruction surgeries.
OBJECTIVE
Implanted grafts are increasingly used by pelvic reconstructive surgeons and gynecologists. In addition, the marketing of a variety of grafts has been aggressively expanded without scientific evidence to support their use. This review aims to provide an update of the current status and role of grafts in reconstructive pelvic surgery and to review the current knowledge of the biology of currently marketed synthetic and biologic grafts.


RESULTS
Xenografts are preferable to human tissue-banked grafts due to more predictable integrity. How these biomaterials compare to synthetics in terms of surgical outcomes has not been well studied, however. Absorbable materials that mimic some behaviors of synthetic and biological materials have been developed. Furthermore, several new techniques have been advocated with limited studies.


CONCLUSIONS
While the reduction of surgical failure rates in vaginal surgery is desirable, the addition of graft materials must demonstrate improvement in anatomical, functional, and quality of life outcomes over time. Furthermore, future complications due to improper placement or movement of a graft and the possible shrinkage of the graft are of concern. Therefore, significant research is necessary for the preclinical testing of materials, and expertise needs to be developed for the management of complications.
Le
Tam H
TH
Department of Obstetrics and Gynecology, Long Beach Memorial Women's Hospital, Long Beach, California, USA. bsgini@hotmail.com
Kon
Leanne
L
Bhatia
Narender N
NN
Ostergard
Donald R
DR
D020341:Absorbable Implants; D016025:Bone Transplantation; D004867:Equipment Design; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008422:Materials Testing; D010384:Pelvic Bones / Q000601:surgery*; D017773:Pelvic Floor / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods*; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000473:pathology / Q000601:surgery