Mesh is a screen like material used during an operation to provide extra support to weak ordamaged tissue or bone. There are three types of surgical mesh:
- Standard Surgical Synthetic. Mesh made from synthetic or manmade materials which will or will not absorb in the body
- Biological Mesh made from animal or human tissues
- Biosynthetic Mesh made from a combination of animal, human or synthetic tissues.
Surgical mesh is most commonly used to repair different types of hernias.
A hernia occurs when an internal part of a body pushes through a part of a weakened muscle or the surrounding tissue wall. This results in a lump or swelling which may or may not be painful. They mainly occur in the abdominal wall which holds the large and small intestines.
Hernias cannot be treated with medication and often need an operation. Hernia repair surgery is carried out using surgery to put the hernia back in its place. During this operation a mesh may be fixed to the muscle or tissue to strengthen it and repair the hernia.
Due to the limited quality of evidence of clinical effectiveness, the use of biological orbiosynthetic mesh in standard hernia repair is Not Routinely Commissioned.
Biological or biosynthetic mesh in hernia repair may only be used in the following clinicalcircumstances following a review by a specialist complex abdominal wallrepair multidisciplinary team:
- The first hernia repair surgery with synthetic surgical mesh did not work and the wound has not healed
- The use of synthetic mesh would not be clinically appropriate for that individual patient,e.g. the mesh would need to be placed directly against the patient’s bowel.
This means, for patients who DO NOT meet the above criteria, the patient’s NHS commissioning organisation (CCG), who is responsible for buying healthcare services on behalf of patients, will only fund the treatment if an Individual Funding Request (IFR) application has shown exceptional clinical need and the CCG supports this.
Advice and further guidance:
- Read the evidence review
- For more information visit www.nhs.uk
- Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.
Treatment policy for patients covered by NHS Birmingham and Solihull CCG