title: Adhesions and meshes: synthetic versus bioprosthetic.
abstract: Adhesions are common after intra-abdominal surgery and are associated with significant morbidity, including bowel obstruction, pain, and infertility. Abdominal wall reconstruction carries the risk of adhesion formation, notably to synthetic or bioprosthetic mesh. This article reviews the pathophysiology of adhesion formation, adhesion grading, and adhesions to synthetic and biologic mesh in vitro and clinically. Bioprosthetic mesh in vitro appears to elicit fewer lower-grade adhesions than synthetic mesh. However, direct comparisons in humans of adhesions with synthetic versus bioprosthetic mesh are lacking. Future studies are warranted to determine whether there are significant differences in clinical outcomes, especially regarding secondary complications from adhesions.
authors.affiliation: Houston, Texas From the Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center.
authors.forename: Kristin C
authors.initials: KC
authors.lastname: Turza
authors.forename: Charles E
authors.initials: CE
authors.lastname: Butler
mesh_terms: D062088:Acellular Dermis / Q000009:adverse effects*; D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects*; D003094:Collagen / Q000627:therapeutic use; D004146:Dioxanes; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D020007:Implants, Experimental; D018836:Inflammation Mediators; D007415:Intestinal Obstruction / Q000209:etiology / Q000517:prevention & control; D008422:Materials Testing; D010537:Peritoneum / Q000293:injuries / Q000378:metabolism / Q000503:physiopathology; D011091:Polyesters; D011126:Polypropylenes; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012086:Reoperation; D013526:Surgical Mesh / Q000009:adverse effects*; D013718:Tensile Strength; D000267:Tissue Adhesions / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: C440568:Alloderm; D001672:Biocompatible Materials; D004146:Dioxanes; D018836:Inflammation Mediators; D011091:Polyesters; D011126:Polypropylenes; C568444:strattice; C095495:glycolide E-caprolactone copolymer; D003094:Collagen