Article information
Abstract
Reinforcement or replacement are increasingly being used in the repair of incisional hernias. In many occasions it is necessary to place the prosthesis in the intraperitoneal plane, for which the so called «composite» or bilaminar prostheses have been designed.
A terminological precision is made in this article, defending the denomination of dual or “composite” prosthesis for these materials, and the different commercial available options at present are related. The numerous suitable alternatives on the market can do that the surgeon is in a labyrinth.
A review of the experimental and clinical studies that support their use, efficiency, safety and complications is included. It concludes by recommending the prostheses for which there is consistent documentary evidence: Bard Composix, Dual Mesh, Parietex Composite, Parietene Composite, and Proceed. However, longer term studies and randomised clinical trials are needed to make stronger recommendations.
Keywords:
Abdominal wall
Incisional hernia
Composite prosthesis
Biomaterials
Resumen
Los materiales protésicos de refuerzo o sustitución se emplean cada vez con mayor frecuencia en el tratamiento de las eventraciones. En muchas ocasiones es necesario ubicar la prótesis en plano intraperitoneal, para lo cual se han diseñado las llamadas prótesis composite o bilaminares.
En este artículo se realiza una precisión terminológica, defendiendo la denominación de prótesis dual o composite para estos materiales y se relacionan las diferentes opciones comerciales disponibles en la actualidad. Las numerosas alternativas elegibles en el mercado pueden hacer que parezca al cirujano que se encuentra en un laberinto.
Se añade una revisión de los estudios experimentales y clínicos que avalan su utilización, su eficacia, su segurid ad y sus complicaciones. Se concluye recomendando las prótesis sobre las que existe un acervo documental más consistente: Bard Composix, Dual Mesh, Parietex, Parietene Composite y, recientemente, Proceed. No obstante, son necesarios estudios a largo plazo y ensayos clínicos aleatorizados para proporcionar recomendaciones de mayor potencia.
Palabras clave:
Pared abdominal
Eventraciones
Prótesis composite
Biomateriales
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