synthetic material — can be a great addition.
There are 2 hybrid meshes on the market, says Bruce Ramshaw,
MD, FACS, chair of the department of surgery at the University of
Tennessee Graduate School of Medicine in Knoxville. One uses a
polypropylene base that's then coated with a biologic graft to help
promote the growth of patient's tissue. The other, approved earlier
this year, uses a similar design but features a biosynthetic material
instead of a biologic.
"The general theoretical benefit is that the biologic/biosynthetic
material on the outside will protect the sensitive structures and the
permanent mesh from bioburden, since the mesh will help the patient
heal and encourage new tissue growth, and then dissipate," says Dr.
Ramshaw. "When it's gone, you'll have a healed wound with the per-
manent mesh still in place for reinforcement."
Dr. Kercher notes that this style is still relatively new and doesn't yet
have proven results, but it could potentially be helpful in situations
where you need a permanent repair near a delicate or contaminated
structure. "One area is a parastomal hernia repair where the patient
has a colostomy, yet there's a hernia around that colostomy," he
explains. "In that situation, the downside of putting in a permanent
synthetic mesh is that it can erode into the bowel and cause a signifi-
cant complication. In theory, a hybrid in that situation would give you
a durable repair that also allows the biologic to provide a level of pro-
tection against the sensitive structure."
Just like biosynthetic options, the biggest benefit may be hybrid's
price compared to biologic mesh, the doctors say. "They're pricing it
closer to reabsorbable synthetic meshes: $2,000 to $4,000 compared
to $8,000 to $20,000 for biologics," says Dr. Ramshaw.
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