Open AccessModified mesh for hernia repair that is adapted to the physiology of the abdominal wall
Author(s) -
Klinge U.,
Klosterhalfen B.,
Conze J.,
Limberg W.,
Obolenski B.,
Öttinger A. P.,
Schumpelick V.
Publication year - 1998
Publication title -
european journal of surgery
Language(s) - English
Resource type - Journals
eISSN - 1741-9271
pISSN - 1102-4151
DOI - 10.1080/110241598750005138
Subject(s) - prolene , ultimate tensile strength , medicine , abdominal wall , surgical mesh , hernia repair , hernia , stiffness , polygon mesh , polypropylene , surgery , biomedical engineering , materials science , composite material , computer science , computer graphics (images)
Objective: To develop a new mesh for hernia repair that is adapted to the physiological forces. Design: Animal experiment. Setting: Surgical Department of the RWTH‐Aachen. Animals: Wistar rats Main outcome measures: Textile analysis, tensile strength, bending stiffness, histology and morphometry. Results: After textile analysis of commercially available meshes in clinical use we defined the physiological forces and constructed a new mesh (Soft Hernia Mesh ® , SHM) based on a combination of non‐absorbable polypropylene and absorbable polyglactin 910. The amount of non‐absorbable material could be reduced to < 30% compared with Marlex ® while still guaranteeing the necessary pulling force of 16 N/cm. Improvements of the hosiery structure improved the symmetrical distribution of the retaining forces in all directions. Compared with the considerable restriction of the abdominal wall mobility by Prolene ® (polypropylene) and Mersilene ® (polyester) meshes there was no increase in the bending stiffness after the implantation of the new mesh. Histological examination showed a pronounced reduction of the inflammatory reaction in the tissues, and the collagen bundles were orientated merely around the mesh filaments instead of forming a scar plate that completely embedded the mesh. Conclusion: Different meshes caused specific histological reactions with changes of their mechanical properties after implantation in rodents. A new mesh with a reduced amount of polypropylene showed both less inflammation and less restriction in the mobility of the abdominal wall though it exceeded the required tensile strength of 16 N/cm. Copyright © 1998 Taylor and Francis Ltd.