| Summary: | A variety of products are available for use as surgical reconstructive materials including biological mesh, absorbable synthetic mesh, and non-absorbable synthetic mesh. Biological meshes are acellular extracts, also known as acellular dermal matrix (ADM) obtained from human (allografts) or non-human (xenografts) sources. Sources of biological mesh include human dermis or fascia lata, porcine dermis or intestine, and bovine dermis or pericardium. It has been suggested that biological mesh products have advantages over synthetic mesh by reducing the risk of infection or rejection; however, the retail cost of biological meshes is high. It is important to clarify whether evidence of significant clinical and cost-effectiveness of biological meshes has been demonstrated to warrant their widespread adoption in surgical practice. CADTH had previously reviewed the evidence for the clinical and cost-effectiveness of biological meshes for a variety of indications, as well as the evidence-based guidelines for their use. However, that report concluded that there was insufficient evidence to clearly establish the place in therapy of biological mesh products. Therefore, there is remaining uncertainty regarding the optimal use of biological mesh in surgical procedures. The purpose of this report is to update the existing clinical and cost-effectiveness evidence, as well as the evidenced-based guidelines regarding the use of biological mesh products
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