Constructive soft tissue remodelling with a biologic extracellular matrix graft: overview and review of the clinical literature.

The extracellular matrix directs all phases of healing following trauma or disease and is therefore nature's ideal scaffold material. When used strategically to induce the repair and restoration of soft tissues following surgery, exogenous extracellular matrix scaffolds interact with surrounding tissues and cells to form a permanent repair without leaving behind a permanent material that can result in chronic inflammation or infection. Biomaterials derived from natural extracellular matrix, such as Surgisis (Cook Medical Incorporated, Bloomington, IN, USA), provide the extracellular components necessary to direct the healing response, allow for the reconstruction of new, healthy tissue and restore mechanical and functional integrity to the damaged site. The 3-dimensional organization of these extracellular components distinguishes the Surgisis mesh from synthetic materials and is associated with better long-term repairs. The tissue response to this biologic mesh is discussed in the context of recent reports on successful clinical applications.