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.
Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.
