Biologic and Bioabsorbable Meshes: The Use of Mesh in Complex Hernia Repairs

Complex ventral hernia repairs pose unique challenges in high-risk patients with impaired tissue quality or contaminated fields. While traditional synthetic meshes are effective, their use in these scenarios carries an increased risk of chronic inflammation and infection. Biologic and bioabsorbable meshes are alternative options designed to provide a temporary scaffolding that supports tissue healing while minimizing foreign body reactions. This paper explores the strengths and limitations of biologic, bioabsorbable, and hybrid meshes, particularly in contaminated or high-risk settings. Biologic meshes, though costly, offer temporary reinforcement and promote tissue integration, while absorbable meshes present a viable alternative with promising safety data. Hybrid meshes, which combine durability with biocompatibility, represent a promising class of materials, particularly for patients with impaired wound healing. As the field advances, further research and comparative studies will be critical to optimizing mesh selection and improving long-term outcomes in complex ventral hernia repair.