A review of patch options in the repair of congenital diaphragm defects.
Repair of congenital diaphragmatic hernia (CDH) continues to pose a dilemma for the pediatric surgeon. While the management of CDH has evolved from surgical urgency to delayed repair after medical optimization with substantial improvements in mortality, morbidity continues to perplex clinicians. Significant morbidity occurs with recurrence, re-recurrence and complications such as obstructions, principally with mesh repair. When primary closure is not possible, mesh repair is indicated. While there are several non-absorbable prosthetic, absorbable biosynthetic and composite mesh types available, the ideal mesh remains elusive. In this article, we reviewed the current materials, reported advantages, and animal and clinical studies of non-absorbable prosthetic, absorbable biosynthetic and composite mesh. However, adequate comparative data are lacking, leaving a wide void for future animal models and clinical studies.
Department of Pediatric Surgery, The Children's Mercy Hospital and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA.
Alessandra C
AC
Gasior
Shawn D
SD
St Peter
D000818:Animals; D001672:Biocompatible Materials; D002986:Clinical Trials as Topic; D006548:Hernia, Diaphragmatic / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D011138:Polytetrafluoroethylene; D013526:Surgical Mesh
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene