Physicomechanical Evaluation of Polypropylene, Polyester, and Polytetrafluoroethylene Meshes for Inguinal Hernia Repair - 10/08/11
, Michael S. Abdo, Margaret M. Frisella, RN, Brent D. Matthews, MD, FACS
Correspondence address: Corey R Deeken, PhD, Department of Surgery, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8109, St Louis, MO 63110Résumé |
Background |
For meshes to be used effectively for hernia repair, it is imperative that engineers and surgeons standardize the terminology and techniques related to physicomechanical evaluation of these materials. The objectives of this study were to propose standard techniques, perform physicomechanical testing, and classify materials commonly used for inguinal hernia repair.
Study Design |
Nine meshes were evaluated: 4 polypropylene, 1 polyester, 1 polytetrafluoroethylene, and 3 partially absorbable. Physical properties were determined through image analysis, laser micrometry, and density measurements. Biomechanical properties were determined through suture retention, tear resistance, uniaxial, and ball burst testing with specimens tested in 2 different orientations. A 1-way ANOVA with Tukey's post-test or a t-test were performed, with p < 0.05.
Results |
Significant differences were observed due to both mesh type and orientation. Areas of interstices ranged from 0.33 ± 0.01 mm2 for ProLite (Atrium Medical Corp) and C-QUR Lite (Atrium Medical Corp) Large to 4.10 ± 0.06 mm2 for ULTRAPRO (Ethicon), and filament diameters ranged from 99.00 ±8.1 μm for ProLite Ultra (Atrium Medical Corp) and C-QUR Lite Small to 338.8 ± 3.7 μm for Parietex Flat Sheet TEC (Covidien). These structural characteristics influenced biomechanical properties such as tear resistance and tensile strength. ProLite Ultra, C-QUR Lite Small, ULTRAPRO and INFINIT (WL Gore & Associates) did not resist tearing as effectively as the others. All meshes exhibited supraphysiologic burst strengths except INFINIT and ULTRAPRO.
Conclusions |
Significant differences exist between the physicomechanical properties of polypropylene, polyester, polytetrafluoroethylene, and partially absorbable mesh prostheses commonly used for inguinal hernia repair. Orientation of the mesh was also shown to be critical for the success of meshes, particularly those demonstrating anisotropy.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : ASTM, BMI, IAP
Plan
| Disclosure Information: Dr Deeken received an honorarium as a consultant for Davol Inc on a separate project not described in this article; Dr Matthews received honoraria and a consulting fee from Atrium Medical Corp and Ethicon Inc for separate projects not described in this article; Dr Matthews received honoraria and research/equipment support from Ethicon EndoSurgery, Karl Storz Endoscopy, Stryker Endoscopy, and WL Gore & Associates, Inc, for separate projects not described in this article. Atrium Medical Corporation donated the mesh products evaluated in this study. Abdo and Frisella have nothing to disclose. |
Vol 212 - N° 1
P. 68-79 - janvier 2011 Retour au numéro
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