title: Biological Meshes for Inguinal Hernia Repair - Review of the Literature.
abstract: BACKGROUND
  Biological meshes are a potential alternative to the synthetic meshes to avoid complications and are used in a contaminated field for incarcerated inguinal hernias. The clinical experiences gained with biological meshes for repair of inguinal hernias are presented in this review.
  
  
  METHODS
  In a literature search of the Medline database using the key word "Biological mesh," 2,277 citations were found. There remained 14 studies in which biological meshes had been used to repair inguinal hernias.
  
  
  RESULTS
  In prospective randomized trials, the use of polypropylene vs. biological meshes was compared in open inguinal hernia repair. There was no difference in the recurrence rate, but differences were observed in the postsurgical pain incidence in favor of the biological mesh. In the remaining retrospective studies, the recurrence rates were also acceptable. The biological mesh was used successfully in a potentially contaminated setting.
  
  
  CONCLUSIONS
  Inguinal hernias can be repaired with biological meshes with reasonable recurrence rate, also as an alternative in a potentially contaminated field.
authors.affiliation: Department of Surgery, Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital , Berlin , Germany.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Köckerling
authors.affiliation: Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter Hospital , Exeter , UK.
authors.forename: Nasra N
authors.initials: NN
authors.lastname: Alam
authors.affiliation: Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter Hospital , Exeter , UK.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Narang
authors.affiliation: Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter Hospital , Exeter , UK.
authors.forename: Ian R
authors.initials: IR
authors.lastname: Daniels
authors.affiliation: Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter Hospital , Exeter , UK.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Smart
keywords: biological mesh; contaminated field; inguinal hernia; pain; recurrence