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Alternatives to mesh
Agree with Dr. Towfigh and Dr. Earle. In addition when you analyze the Gore BioA study the data is questionable because the exact types of hernias within the study is u clear. If you look at the range for time of surgery and size of hernia defect you are quick to question whether there is some padding of the data going on with small, easily repaired defects. In my experience there is no abdominal wall reconstruction hernia that take 60 minutes or has a defect size in the 10cm2 range. I plan to continue aggressive selection of patients and use permanent as much as possible. In addition I am looking at combined products that have both biologic and synthetic products in a single mesh.