Abstract
Preserving patients' native tissues has posed many challenges for surgeons. Increased
life expectancy is leading to a proportionately older surgical population with weaker
tissues. The growing population of morbidly obese patients in addition to those with
multiple comorbidities which influence the native strength and perfusion of tissues
compounds the surgeon's challenge. Certainly, there is a rising demand for materials
to replace or augment a patient's native tissue when it has been compromised. Over
time, the number of products available has increased substantially. The ideal substitute, however, is debatable. The manufacturing and processing of these materials
has become more complex and this has resulted in a significant increase in cost. The
composition of the mesh, clinical scenario, and operative technique all interact to
impact the long-term results. Surgeons require a thorough understanding of these products
to guide proper selection and use, to ensure optimal outcomes for patients, and to
properly steward financial resources. This review will outline the properties of commonly
used materials, highlighting the strength and weakness of each. It will then discuss
recommendations regarding mesh selection, coding, and reimbursement. While general
principles and trends can be highlighted, further studies of biologic versus synthetic
meshes are clearly necessary.
Keywords
biological mesh - synthetic mesh - coding
