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Published in: Surgical Endoscopy 9/2005

01-09-2005 | Original article

Comparative investigation of alloplastic materials for hernia repair with improved methodology

Authors: M. Kapischke, K. Prinz, J. Tepel, J. Tensfeldt, T. Schulz

Published in: Surgical Endoscopy | Issue 9/2005

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Abstract

Background:

A variety of alloplastic materials are used for hernia repair. We discuss the long-term stability and possible shrinkage of these materials. In the past, measurement of pore sizes was used to study the physical properties of alloplastic meshes. The aim of this study was to evaluate the measurement of pore sizes with regard to its correlation to possible mesh alteration.

Methods:

The water absorption of different polypropylene (PP) and polyester (PE) mesh materials under defined conditions was studied. For shrinkage studies, meshes were stored in formaldehyde, distilled water, saline solution, trypsin solution, urea solution, and hydrogen peroxide. The measurement of the relation between material and pore was evaluated to investigate the potential shrinking and enlargement processes. This material–pore index (MPI) before as well as 1, 7, and 14 days after incubation was measured.

Results:

In comparison to measuring single pore sizes, MPI determination is the more efficient method to evaluate the possible shrinking or enlargement processes of alloplastic materials. With this technique, incorrect determination of pore sizes due to the dynamic textile structure of meshes and to shrinkage or enlargement, is excluded. All tested alloplastic materials showed an insignificant increase in water absorption under the condition of rehydration up to 0.4%. We did not observe variances in the material in shrinking or enlargement.

Conclusions:

MPI was found to be more reliable than measuring single pores to investigate possible external influences on polymer materials. Biomaterials such as PP and PE proved to be absolutely inert under various in vitro conditions.
Literature
1.
go back to reference Amid PK, (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery Hernia 1: 15–21 Amid PK, (1997) Classification of biomaterials and their related complications in abdominal wall hernia surgery Hernia 1: 15–21
2.
go back to reference Amid PK, (2000) Intraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula Br J Surg 87: 1436–1437CrossRef Amid PK, (2000) Intraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula Br J Surg 87: 1436–1437CrossRef
3.
go back to reference Amid PK, (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty Hernia 7: 13–16CrossRefPubMed Amid PK, (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty Hernia 7: 13–16CrossRefPubMed
4.
go back to reference Anwar S, (2003) The use of prosthetics in hernia repair Hosp Med 64: 34–35PubMed Anwar S, (2003) The use of prosthetics in hernia repair Hosp Med 64: 34–35PubMed
5.
go back to reference Arnaud JP, Tuech JJ, Pessaux P, Hadchity Y (1999) Surgical treatment of postoperative incisional hernias by intraperitoneal insertion of Dacron mesh and an aponeurotic graft: a report on 250 cases Arch Surg 134: 1260–1262CrossRefPubMed Arnaud JP, Tuech JJ, Pessaux P, Hadchity Y (1999) Surgical treatment of postoperative incisional hernias by intraperitoneal insertion of Dacron mesh and an aponeurotic graft: a report on 250 cases Arch Surg 134: 1260–1262CrossRefPubMed
6.
go back to reference Arroyo A, Garcia P, Perez F, Andreu J, Candela F, Calpena R (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults Br J Surg 88: 1321–1323CrossRefPubMed Arroyo A, Garcia P, Perez F, Andreu J, Candela F, Calpena R (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults Br J Surg 88: 1321–1323CrossRefPubMed
8.
go back to reference Coda A, Bendavid R, Botto-Micca F, Bossotti M, Bona A (2003) Structural alterations of prosthetic meshes in humans Hernia 7: 29–34PubMed Coda A, Bendavid R, Botto-Micca F, Bossotti M, Bona A (2003) Structural alterations of prosthetic meshes in humans Hernia 7: 29–34PubMed
9.
go back to reference DeBord JR, (1998) The historical development of prosthetics in hernia surgery Surg Clin North Am 78: 973–1006CrossRefPubMed DeBord JR, (1998) The historical development of prosthetics in hernia surgery Surg Clin North Am 78: 973–1006CrossRefPubMed
10.
go back to reference Durden JG, Pemberton LB (1974) Dacron mesh in ventral and inguinal hernia repair Am Surg 60: 662–665 Durden JG, Pemberton LB (1974) Dacron mesh in ventral and inguinal hernia repair Am Surg 60: 662–665
11.
go back to reference Ghadimi BM, Langer C, Becker H (2002) The carcinogenic potential of biomaterials in hernia surgery Chirurg 73: 833–837CrossRefPubMed Ghadimi BM, Langer C, Becker H (2002) The carcinogenic potential of biomaterials in hernia surgery Chirurg 73: 833–837CrossRefPubMed
12.
go back to reference Grant AM, (2002) Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data Hernia 6: 130–136CrossRefPubMed Grant AM, (2002) Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data Hernia 6: 130–136CrossRefPubMed
13.
go back to reference Klinge U, Klosterhalfen B, Muller M, Ottinger AP, Schumpelick V (1998) Shrinking of polypropylene mesh in vivo: an experimental study in dogs Eur J Surg 164: 965–969CrossRefPubMed Klinge U, Klosterhalfen B, Muller M, Ottinger AP, Schumpelick V (1998) Shrinking of polypropylene mesh in vivo: an experimental study in dogs Eur J Surg 164: 965–969CrossRefPubMed
14.
go back to reference Klosterhalfen B, Klinge U, Hermanns B, Schumpelick V (2000) Pathology of traditional surgical nets for hernia repair after long-term implantation in humans Chirurg 71: 43–51PubMed Klosterhalfen B, Klinge U, Hermanns B, Schumpelick V (2000) Pathology of traditional surgical nets for hernia repair after long-term implantation in humans Chirurg 71: 43–51PubMed
15.
go back to reference LeBlanc KA, (2001) Complications associated with the plug-and-patch method of inguinal herniorrhaphy Hernia 5: 135–138CrossRefPubMed LeBlanc KA, (2001) Complications associated with the plug-and-patch method of inguinal herniorrhaphy Hernia 5: 135–138CrossRefPubMed
16.
go back to reference Sher W, Pollack D, Paulides CA, Matsumoto T (1980) Repair of abdominfal wall defects: Gore-Tex vs Marlex graft. Am Surg 46: 618–623 Sher W, Pollack D, Paulides CA, Matsumoto T (1980) Repair of abdominfal wall defects: Gore-Tex vs Marlex graft. Am Surg 46: 618–623
17.
go back to reference Usher FC, Alien JE, Crosthwait RW (1962) Polypropylene monofilament; a new biologically inert suture for closing contaminated wounds J Am Med Assoc 79: 780–786 Usher FC, Alien JE, Crosthwait RW (1962) Polypropylene monofilament; a new biologically inert suture for closing contaminated wounds J Am Med Assoc 79: 780–786
18.
go back to reference Witherspoon P, Bryson G, Wright DM, Reid R, O’Dwyer PJ (2004) Carcinogenic potential of commonly used hernia repair prostheses in an experimental model Br J Surg 91: 368–372CrossRefPubMed Witherspoon P, Bryson G, Wright DM, Reid R, O’Dwyer PJ (2004) Carcinogenic potential of commonly used hernia repair prostheses in an experimental model Br J Surg 91: 368–372CrossRefPubMed
19.
go back to reference Wulfhorst B (1989) Polypropylene fibres Chemiefaser/Textilindustrie 39: 3–11 Wulfhorst B (1989) Polypropylene fibres Chemiefaser/Textilindustrie 39: 3–11
Metadata
Title
Comparative investigation of alloplastic materials for hernia repair with improved methodology
Authors
M. Kapischke
K. Prinz
J. Tepel
J. Tensfeldt
T. Schulz
Publication date
01-09-2005
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 9/2005
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-004-2235-y

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