title: Bioprosthetic tissue matrices in complex abdominal wall reconstruction.
abstract: BACKGROUND
  Complex abdominal defects are difficult problems encountered by surgeons in multiple specialties. Although current evidence supports the primary repair of these defects with mesh reinforcement, it is unclear which mesh is superior for any given clinical scenario. The purpose of this review was to explore the characteristics of and clinical relevance behind bioprosthetic tissue matrices in an effort to better clarify their role in abdominal wall reconstruction.
  
  
  METHODS
  We reviewed the peer-reviewed literature on the use of bioprosthetic mesh in human subjects. Basic science articles and large retrospective and prospective reviews were included in author's analysis. The clinical performance and characteristics of 13 bioprosthetic tissue matrices were evaluated.
  
  
  RESULTS
  The majority of the products evaluated perform well in contaminated fields, where the risk of wound-healing difficulties is high. Clinical outcomes, which included infection, reherniation, and bulge formation, were variable, and the majority of the studies had a mean follow-up of less than 24 months.
  
  
  CONCLUSIONS
  Although bioprosthetic matrix has a multitude of indications within the growing field of abdominal wall reconstruction, the functionality, regenerative capacity, and long-term fate of these products have yet to be fully established. Furthermore, the clinical performance, indications, and contraindications for each type of matrix need to be fully evaluated in long-term outcome studies.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, Md.; and Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Broyles
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, Md.; and Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Abt
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, Md.; and Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Sacks
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, Md.; and Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Butler