Occasionally an adequate hernia repair is impossible because of lack of suitable tissue. This situation is encountered in the massive or recurrent hernias, in elderly patients in a state of poor nutrition, and in those who have a loss of tissue following suppuration or surgical excision of neoplastic lesions. In such instances it is necessary to provide a graft or prosthesis to effect the repair. At times closure may be obtained under tension requiring reinforcement. Many materials have been used over the years, and new ones continue to be introduced, indicating that none thus far is satisfactory in all respects.
The metals, such as Tantalum,7,10,15,25 stainless steel,12,23 and silver,3 fabricated into weaves, meshes, ring chains, and filigrees, have been used extensively. The disadvantages associated with their use are lack of pliability, the possibility of erosion of viscera or skin, the occurrence of persistent postoperative pain in the