Skeletal muscle tissue engineering approaches to abdominal wall hernia repair.

Abdominal wall hernias resulting from prior incisions are a common surgical complication affecting hundreds of thousands of Americans each year. The negative consequences associated with abdominal hernias may be considerable, including pain, bowel incarceration, vascular disruption, organ loss, and death. Current clinical approaches for the treatment of abdominal wall hernias focus on the implantation of permanent biomaterial meshes or acellular xenografts. However, these approaches are not infrequently associated with postoperative infections, chronic sinuses, or small bowel obstruction. Furthermore, the most critical complication, hernia recurrence, has been well described and may occur in a large percentage of patients. Despite many advances in repair techniques, wound healing and skeletal muscle regeneration is limited in many cases, resulting in a decrease in abdominal wall tissue function and contributing to the high hernia recurrence rate. This review will give an overview of skeletal muscle anatomy, skeletal muscle regeneration, and herniation mechanisms, as well as discuss the current and future clinical solutions for abdominal wall hernia repair. (c) 2008 Wiley-Liss, Inc.