Kalaba Surge, Gerhard Ethan, Winder Joshua S, Pauli Eric M, Haluck Randy S, Yang Jian
Department of Biomedical Engineering, Materials Research Institute, The Huck Institutes of The Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA.
Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA.
Bioact Mater. 2016 Sep;1(1):2-17. doi: 10.1016/j.bioactmat.2016.05.002. Epub 2016 May 30.
Hernia repair is one of the most commonly performed surgical procedures worldwide, with a multi-billion dollar global market. Implant design remains a critical challenge for the successful repair and prevention of recurrent hernias, and despite significant progress, there is no ideal mesh for every surgery. This review summarizes the evolution of prostheses design toward successful hernia repair beginning with a description of the anatomy of the disease and the classifications of hernias. Next, the major milestones in implant design are discussed. Commonly encountered complications and strategies to minimize these adverse effects are described, followed by a thorough description of the implant characteristics necessary for successful repair. Finally, available implants are categorized and their advantages and limitations elucidated, including non-absorbable and absorbable (synthetic and biologically derived) prostheses, composite prostheses, and coated prostheses. This review not only summarizes the state of the art in hernia repair, but also suggests future research directions toward improved hernia repair utilizing novel materials and fabrication methods.
疝修补术是全球最常开展的外科手术之一，拥有数十亿美元的全球市场。植入物设计仍然是成功修复和预防复发性疝的关键挑战，尽管取得了重大进展，但尚无适用于每种手术的理想补片。本综述首先描述疾病的解剖结构和疝的分类，总结假体设计朝着成功疝修补发展的历程。接下来，讨论植入物设计的主要里程碑。描述了常见的并发症以及将这些不良影响降至最低的策略，随后详细介绍了成功修复所需的植入物特性。最后，对现有植入物进行分类并阐明其优缺点，包括不可吸收和可吸收（合成和生物衍生）假体、复合假体和涂层假体。本综述不仅总结了疝修补术的现状，还提出了利用新型材料和制造方法改进疝修补术的未来研究方向。
