Author's reply: Parastomal hernia (Br J Surg 2003; 90: 784-793)

Sir The use of porcine collagen mesh may be a promising technique, but are unaware of any published data to support the claims of a potential for reduced infection risk when used in the repair of parastomal hernias. The ideal biomaterial to use for the repair of such hernias is yet to be developed. There is a need for good prospective randomized trials to study both the prevention and treatment of parastomal hernias. Large numbers of patients will be required, almost certainly requiring multicentre participation. Co-ordination of such trials by bodies such as the Association of Coloproctology of Great Britain and Ireland, the Colorectal Surgical Society of Australasia or the American Society of Colon and Rectal Surgeons may be the best method of facilitating the design and timely completion of these trials.