In short
Tutomesh/Tutopatch (RTI) and Veritas (Synovis/Baxter) are bovine pericardium matrices originally developed for general soft-tissue and cardiovascular/hernia repair and later applied to breast reconstruction. SurgiMend (Integra) is a fetal-bovine dermal ADM — different tissue. ExaShape (ABC) is a bovine pericardium biological matrix purpose-built for breast reconstruction, with dedicated prepectoral and direct-to-implant configurations. Selection remains a clinical decision based on the case, evidence and the IFU.
Several bovine-derived acellular matrices are used to support the implant in reconstruction, and they are easily conflated. Two distinctions matter clinically: tissue of origin (pericardium vs dermis) and design intent (a general-purpose surgical membrane vs a device engineered for breast reconstruction).
Pericardium-derived matrices — Tutomesh/Tutopatch, Veritas, Exaflex and ExaShape — are dense, collagen-rich membranes. SurgiMend is a dermal matrix (ADM) derived from fetal/neonatal bovine skin, so it sits in the ADM family rather than the pericardium family, despite also being bovine.
| Attribute | ExaShape® (ABC) | Tutomesh® / Tutopatch® (RTI) | Veritas® (Synovis/Baxter) | SurgiMend® (Integra) |
|---|---|---|---|---|
| Tissue of origin | Bovine pericardium | Bovine pericardium | Bovine pericardium | Fetal/neonatal bovine dermis (ADM) |
| Matrix family | Biological (acellular) pericardial | Biological (acellular) pericardial | Biological (acellular) pericardial | Biological (acellular) dermal (ADM) |
| Original design intent | Breast reconstruction (purpose-built) | General soft-tissue / cardiovascular / hernia, applied to breast | General soft-tissue repair, applied to breast | Soft-tissue / ADM, used in breast |
| Breast-specific configurations | Grid sheet, PREPEC (meshed), BioShield Pocket / PRO / 3D, NAC, Expander | Flat / fenestrated sheet | Flat sheet | Flat sheet (various thicknesses) |
| Meshed / pocket options | Yes (meshed + pre-formed pockets) | Fenestrated (Tutomesh) | No pre-formed pocket | No pre-formed pocket |
| Regulatory (EU) | CE-marked, EU MDR 2017/745 | CE-marked | CE-marked | CE-marked |
| Breast-specific published data | Mazzocchi 2022; De Vita 2024 (multicentre prepectoral DTI) | Small breast series; head-to-head vs SurgiMend (45 cases) | Xenograft series; high long-term resorption reported in one dataset | Tissue-expander series; head-to-head vs Tutomesh |
How to read this. Entries summarise manufacturer information and published literature; product ranges and specifications change, so confirm current details and Instructions for Use with each manufacturer. Clinical figures come from separate studies with different populations and definitions, so they are indicative, not a like-for-like head-to-head.
Many bovine pericardium membranes reached breast reconstruction after first being developed for other indications, and are supplied as a flat sheet the surgeon cuts and shapes intraoperatively. ExaShape was developed specifically for breast reconstruction and is sourced from cattle under 24 months old, with a bilayer configuration and a range of breast-specific formats:
These formats aim to reduce intraoperative membrane preparation and match the anatomy of prepectoral and direct-to-implant techniques — a practical difference from a single general-purpose sheet.
As a class, bovine pericardium matrices report complication rates broadly comparable to ADM in breast reconstruction, though ADM has the larger published evidence base. Product-level data are uneven: Veritas has shown comparable early complications but high long-term resorption in one dataset (Mofid 2012); Tutomesh and SurgiMend were compared head-to-head in a 45-case series (Chattha 2017); and ExaShape has device-specific prospective data (Mazzocchi 2022) plus the largest multicentric prepectoral DTI bovine-pericardium series at the time of publication (De Vita 2024). A defensible in-house comparison replaces every published figure with your own audited, consistently-defined outcomes.
Common questions
Tutomesh/Tutopatch (RTI Surgical) and Veritas (Synovis/Baxter) are acellular bovine pericardium matrices originally developed for general soft-tissue and cardiovascular/hernia repair and later applied to breast reconstruction. SurgiMend (Integra) is different tissue entirely — a fetal/neonatal bovine dermal acellular matrix (an ADM). ExaShape (Advanced Biomedical Concept) is a bovine pericardium biological matrix engineered specifically for breast reconstruction, with dedicated prepectoral and direct-to-implant configurations.
No. SurgiMend is a fetal/neonatal bovine dermal acellular dermal matrix (ADM) — derived from bovine dermis, not pericardium. Tutomesh, Tutopatch, Veritas, Exaflex and ExaShape are bovine pericardium matrices. Although all are bovine-derived biological scaffolds, dermis and pericardium differ in structure, thickness and handling.
Several bovine pericardium devices are used in breast reconstruction, but many were adapted from other surgical indications. ExaShape is designed from the ground up for breast reconstruction and offers breast-specific configurations — including PREPEC (meshed), the BioShield Pocket family (pre-formed pockets, including a 3D variant), a Grid sheet, an NAC device and an expander wrap — rather than a single general-purpose sheet.
Bovine pericardium matrices as a class report complication rates broadly comparable to ADM in breast reconstruction, though the ADM evidence base is larger. Product-level data vary: a head-to-head series compared SurgiMend and Tutomesh (45 cases); Veritas has reported favourable early complications but also high long-term resorption in one dataset; and ExaShape-specific prospective data include Mazzocchi 2022 and the De Vita 2024 multicentre prepectoral DTI series. Figures come from separate studies with different populations, so they are indicative rather than head-to-head.
Selection is a clinical decision based on the individual case, available evidence, handling preference, configuration needs, supply and cost, and the applicable Instructions for Use. This page is educational and is not a substitute for clinical judgement or the IFU.
From the ExaShape® biological matrix for breast reconstruction to the EXAFAT® fat-grafting system — explore the full range of ABC devices.
Explore our productsSend us a message and our team will get back to you within 1–2 business days.