ABSTRACT
This chapter describes the meshes available, and defines their indications for use. It provides a synopsis of the evidence base for each. The ideal characteristics of a mesh for hernia repair have been described in a European Hernia Society congress report and should exhibit the following characteristics: excellent tissue integration, minimal shrinkage, good memory, no potential for adhesion to bowel, easy to use and cost effective. The purpose of meshes in abdominal wall hernia repair is twofold. Primarily there is reinforcement of tissue, which provides stabilisation of the abdominal wall and is dependent upon the ‘out of the packet’ tensiometric and rheometric physical properties of the mesh, which should be sufficient to withstand the forces within the abdominal wall; it is noteworthy that a greater degree of strength is required if a hernial defect is bridged. The second purpose is to facilitate ingrowth of native collagen scar tissue to allow complete integration and facilitate a durable repair.
