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March 16, 1984

Biomaterials and Herniology

Author Affiliations

Fresh Meadows, NY

JAMA. 1984;251(11):1431-1432. doi:10.1001/jama.1984.03340350025018

To the Editor.—  The participants at the Conference on the Clinical Applications of Biomaterials held at the National Institutes of Health were "charged with addressing the area of greatest clinical need in which the state of the art today is feasible and practical."1 Their report cited biomaterial applications in cardiovascular surgery, plastic surgery, orthopedics, neurosurgery, ophthalmology, otolaryngology, nephrology, and urology. There was no mention of mesh prostheses for groin and other abdominal wall hernias—a serious omission.Groin herniorrhaphy is the third most common primary operative procedure. Adult inguinal herniorrhaphy constitutes 15% of general surgical operations.2 A proper hernial repair implies an anatomic reconstruction without tension so that collagen synthesis can reestablish a stable aponeurotic structure. In some cases the tissue quality is so poor or the hernial defect so large that a biomaterial is needed to bridge the gap.From January 1980 through September 1983, I found it