A variety of polymeric synthetic hernia mesh prosthesis with surface treatment on at least one tissue-facing surface to control tissue adhesion are disclosed including heparin surface treatment which provides heparin present in an amount to yield heparin bioactivity of at least one of i) an ATIII binding of at least 2 pmol/cm2, and ii) a thrombin deactivation of at least 0.2 IU/cm2 an acrylic surface treatment for coupling thereto of a heparin surface treatment, a collagen surface treatment or both and an amino-functional polysiloxane surface treatment for coupling thereto of a heparin surface treatment. The synthetic hernia mesh may be formed of monofilament or multifilament polypropylene or polyester, and may be formed as a multi-layer prosthesis with an outer layer formed of a polymeric synthetic hernia mesh with surface treatment to control tissue adhesion coupled to one or more polymeric synthetic hernia meshes without such surface treatments.
