Collagenous tissue as a biomaterial possesses many favourable characte
ristics and advantages over synthetic materials. The resemblance to hu
man tissue suggests that it has a performance advantage over alternati
ve materials. This advantage has been exploited to produce clinical de
vices that have been implanted in patients for more than a quarter of
a century. The method of treating collagenous tissue for bioprostheses
has developed from crude exposure of tissue to chemicals to a sophist
icated level of considering the biochemical, chemical, engineering and
clinical aspects of the process. This review focuses on the various c
hemical and physical treatments that have made the bioprostheses possi
ble, highlighting the chemical agents and the cross-linking mechanism
involved. (C) 1996 Elsevier Science Limited.