ANZ J Surg. 2026 Jul 6. doi: 10.1111/ans.70833. Online ahead of print.

ABSTRACT

BACKGROUND: Bovine pericardium (BP) is increasingly utilised in complex surgical reconstruction because of its favourable biological and mechanical properties. Although widely used in cardiovascular surgery, its role in general surgery remains less well characterised.

METHODS: A narrative review was conducted to synthesise available evidence regarding the biological properties, preparation methods, tissue integration and clinical applications of BP in general surgery.

RESULTS: BP demonstrates favourable tensile strength, low antigenicity, and reliable biocompatibility. Available evidence, largely from observational studies and small case series, supports its use across a variety of general and subspecialty surgical settings including vena cava and portal vein reconstruction, diaphragmatic hernia repair, abdominal wall reconstruction, and arteriovenous fistula formation. Compared with synthetic grafts, BP may offer advantages in contaminated or infected fields, although comparative data is limited. Tissue integration varies according to preparation technique, with decellularised grafts demonstrating improved cellular infiltration and reduced calcification. Novel applications, including reconstructing the empty pelvis after exenteration, are emerging.

CONCLUSION: BP is a durable and individually adaptable biomaterial with expanding applications in general surgery. Its favourable handling characteristics and biological integration make it a valuable adjunct in complex reconstructions, although further studies are required to better define its long-term outcomes and comparative effectiveness.

PMID:42409595 | DOI:10.1111/ans.70833