Design of surgical meshes - an engineering perspective.

There is an increasing use of meshes to surgically repair or reconstruct anatomical defects. The surgical mesh firmly augments the debilitated area, provides a tension-free repair and facilitates the incorporation of fibrocollagenous tissue into the surgical mesh. However, the variant of mesh that facilitates best surgical practice is controversial. Surgical meshes have been predominantly designed with greater emphasis being placed on enhancing the biocompatibility of surgical meshes rather than on the engineering parameters. There is abundant evidence indicating a relationship between post-operative complications and the mesh design. Yet, the design of surgical meshes from an engineering perspective has to come to fruition. This article endeavours to present a synopsis of the current state of the science of surgical meshes, their clinical applications and the current trends in research.

[1]  Usher Fc The repair of incisional and inguinal hernias. , 1970 .

[2]  B. Ramshaw,et al.  Comparison of Tissue Integration between Polyester and Polypropylene Prostheses in the Preperitoneal Space , 2003, The American surgeon.

[3]  W. Zin,et al.  Respiratory mechanics after prosthetic reconstruction of the chest wall in normal rats. , 1998, Chest.

[4]  B. Klosterhalfen,et al.  Functional and morphologic properties of a modified mesh for inguinal hernia repair , 2002, World Journal of Surgery.

[5]  U. G. Dailey,et al.  Incisional hernia repaired with tanatalum gauze; preliminary report. , 1948, American journal of surgery.

[6]  U Klinge,et al.  Impact of polymer pore size on the interface scar formation in a rat model. , 2002, The Journal of surgical research.

[7]  W. Bartlett AN IMPROVED FILIGREE FOR THE REPAIR OF LARGE DEFECTS IN THE ABDOMINAL WALL , 1903, Annals of surgery.

[8]  J. Bellón,et al.  Evaluation of a new composite prosthesis (PL-PU99) for the repair of abdominal wall defects in terms of behavior at the peritoneal interface , 2002, World Journal of Surgery.

[9]  R. Goldberg,et al.  Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. , 2001, American journal of obstetrics and gynecology.

[10]  T. Young,et al.  Human monocyte adhesion and activation on crystalline polymers with different morphology and wettability in vitro. , 2000, Journal of biomedical materials research.

[11]  J. Bellón,et al.  Effect of phosphatidylcholine on the process of peritoneal adhesion following implantation of a polypropylene mesh prosthesis. , 1996, Biomaterials.

[12]  K. LeBlanc,et al.  Tissue attachment strength of prosthetic meshes used in ventral and incisional hernia repair , 2002, Surgical Endoscopy.

[13]  G. Fourtanier,et al.  Expanded polytetrafluoroethylene patches used in the intraperitoneal or extraperitoneal position for repair of incisional hernias of the anterolateral abdominal wall. , 1997, American journal of surgery.

[14]  P. Scholten,et al.  Surgical support and suspension of genital prolapse, including preservation of the uterus, using the Gore-Tex soft tissue patch (a preliminary report). , 1993, European journal of obstetrics, gynecology, and reproductive biology.

[15]  V. Cumberland,et al.  A PRELIMINARY REPORT ON THE USE OF PREFABRICATED NYLON WEAVE IN THE REPAIR OF VENTRAL HERNIA , 1952, The Medical journal of Australia.

[16]  M. Novotney,et al.  Retrorectus prosthetic mesh repair of midline abdominal hernia. , 1997, American journal of surgery.

[17]  S. B. Young,et al.  Mersilene mesh sling: short- and long-term clinical and urodynamic outcomes. , 2001, American journal of obstetrics and gynecology.

[18]  U. Spetzger,et al.  Individual prefabricated titanium implants and titanium mesh in skull base reconstructive surgery. A report of cases , 2004, European Archives of Oto-Rhino-Laryngology and Head & Neck.

[19]  S. Greenstein,et al.  Evaluation of polylactic acid-carbon mesh for repair of ventral herniorrhaphy. , 1986, American journal of surgery.

[20]  U Klinge,et al.  Functional assessment and tissue response of short- and long-term absorbable surgical meshes. , 2001, Biomaterials.

[21]  H. Torloni,et al.  A retrospective study of the use of bovine pericardium, dura mater, and polypropylene mesh as reinforcement materials in abdominal and thoracic wall reconstruction , 1995 .

[22]  G. Mickisch,et al.  Experiences with prosthetic reconstruction of the trachea and bifurcation. , 1985, Thorax.

[23]  R. Bleichrodt,et al.  Expanded polytetrafluoroethylene patch versus polypropylene mesh for the repair of contaminated defects of the abdominal wall. , 1993, Surgery, gynecology & obstetrics.

[24]  A. Coda,et al.  Structural alterations of prosthetic meshes in humans , 2003, Hernia.

[25]  Hojoong Kim,et al.  Replacement of a Tracheal Defect with Autogenous Mucosa Lined Tracheal Prosthesis Made from Polypropylene Mesh , 2001, ASAIO journal.

[26]  Wantz Ge Incisional hernioplasty with Mersilene. , 1991 .

[27]  R. Minns,et al.  The repair of inguinal hernias using carbon fibre patches--a five-year follow-up. , 1993, Clinical materials.

[28]  U Klinge,et al.  Foreign body reaction to meshes used for the repair of abdominal wall hernias. , 1999, The European journal of surgery = Acta chirurgica.

[29]  U Klinge,et al.  Modified mesh for hernia repair that is adapted to the physiology of the abdominal wall. , 2003, The European journal of surgery = Acta chirurgica.

[30]  M Kellomäki,et al.  Bioabsorbable scaffolds for guided bone regeneration and generation. , 2000, Biomaterials.

[31]  B. Klosterhalfen,et al.  Veränderung der bauchwandmechanik nach mesh-implantation Experimentelle veränderung der mesh-stabilität Alteration of abdominal wall mechanics after mesh implanation. Experimental alteration of mesh stability , 2004, Langenbecks Archiv für Chirurgie.

[32]  P. Zimmern,et al.  EROSION OF WOVEN POLYESTER SYNTHETIC ("Protegen") PUBOVAGINAL SLING , 1999 .

[33]  E. Utiyama,et al.  Elective colonic operation and prosthetic repair of incisional hernia: does contamination contraindicate abdominal wall prosthesis use? , 2000, Journal of the American College of Surgeons.

[34]  N. Kohli,et al.  Mesh Erosion After Abdominal Sacrocolpopexy , 1998, Obstetrics and gynecology.

[35]  J. Barkun,et al.  EU Hernia Trialists Collaboration. Laparoscopic compared with open methods of groin hernia repair: systematic review of randomised controlled trials. Br J Surg 87: 860-867 , 2000 .

[36]  R. Tukkie,et al.  Chest wall reconstruction with degradable processed sheep dermal collagen in dogs. , 1991, The Annals of thoracic surgery.

[37]  U Klinge,et al.  Shrinking of polypropylene mesh in vivo: an experimental study in dogs. , 2003, The European journal of surgery = Acta chirurgica.

[38]  C. Mcsherry,et al.  Spermatic granuloma. An uncommon complication of the tension-free hernia repair. , 1996 .

[39]  D. Ridder The Use of Biomaterials in Reconstructive Urology , 2002 .

[40]  J. Naim,et al.  Reduction of postoperative adhesions to Marlex mesh using experimental adhesion barriers in rats. , 1993, Journal of laparoendoscopic surgery.

[41]  D J Mackenzie,et al.  Orbital floor repair with titanium mesh screen. , 1999, The Journal of cranio-maxillofacial trauma.

[42]  B. Klosterhalfen,et al.  Functional and morphological evaluation of different polypropylene-mesh modifications for abdominal wall repair. , 1998, Biomaterials.

[43]  D. E. Szilagyi,et al.  Tantalum gauze in the repair of large postoperative ventral hernias. , 1948, Archives of surgery.

[44]  B. Thanopoulos,et al.  Transcatheter closure of perimembranous ventricular septal defects with the Amplatzer asymmetric ventricular septal defect occluder: preliminary experience in children , 2003 .

[45]  L. Lenke,et al.  Mesh cages for spinal deformity in adults. , 2002, Clinical orthopaedics and related research.

[46]  D. Jenkins,et al.  The use of flexible carbon fibre in the repair of experimental large abdominal incisional hernias , 1980, The British journal of surgery.

[47]  B Pourdeyhimi,et al.  Porosity of surgical mesh fabrics: new technology. , 1989, Journal of biomedical materials research.

[48]  A. Koontz Preliminary Report on the Use of Tantalum Mesh in the Repair of Ventral Hernias. , 1948, Annals of surgery.

[49]  E. Myers,et al.  Vaginal mesh erosion after abdominal sacral colpopexy. , 2001, American journal of obstetrics and gynecology.

[50]  A. Pans,et al.  Use of an absorbable polyglactin mesh for the prevention of incisional hernias. , 1995, Acta chirurgica Belgica.

[51]  N. Kama,et al.  Autologous skin graft, human dura mater and polypropylene mesh for the repair of ventral abdominal hernias: an experimental study. , 1999, The European journal of surgery = Acta chirurgica.

[52]  B. Klosterhalfen,et al.  Do multifilament alloplastic meshes increase the infection rate? Analysis of the polymeric surface, the bacteria adherence, and the in vivo consequences in a rat model. , 2002, Journal of biomedical materials research.

[53]  U Klinge,et al.  Influence of polyglactin-coating on functional and morphological parameters of polypropylene-mesh modifications for abdominal wall repair. , 1999, Biomaterials.

[54]  R. White,et al.  Results of repair of large central hernias with tantalum mesh. , 1957, American journal of surgery.

[55]  J. Bellón,et al.  Macrophage response to experimental implantation of polypropylene prostheses. , 1994, European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes.

[56]  J. Duron,et al.  Large abdominal incisional hernias: Repair by fascial approximation reinforced with a stainless steel mesh , 1986, The British journal of surgery.

[57]  F. Ulmer,et al.  Influence of Mesh Materials on Collagen Deposition in a Rat Model , 2002, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[58]  W. Hopkins,et al.  The use of Mersilene mesh in adult inguinal and femoral hernia repairs: a comparison with classic techniques. , 1994, The American surgeon.

[59]  B. Blomstedt,et al.  Suture materials and wound infection. An experimental study. , 1978, Acta chirurgica Scandinavica.

[60]  R. White The effect of porosity and biomaterial on the healing and long-term mechanical properties of vascular prostheses. , 1988, ASAIO transactions.

[61]  A. Cameron,et al.  Carbon‐fibre versus Marlex mesh in the repair of experimental abdominal wall defects in rats , 1985, The British journal of surgery.

[62]  J. Bellón,et al.  The structure of a biomaterial rather than its chemical composition modulates the repair process at the peritoneal level. , 2002, American journal of surgery.

[63]  G. Piérard,et al.  A comparison of intraperitoneal prostheses for the repair of abdominal muscular wall defects in rats. , 1992, European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes.

[64]  W. P. Reed,et al.  Long-term complications associated with prosthetic repair of incisional hernias. , 1998, Archives of surgery.

[65]  I. Lichtenstein,et al.  [Biomaterials and hernia surgery. Rationale for using them]. , 1995, Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva.

[66]  P. Hardiman,et al.  Sacrospinous vault suspension and abdominal colposacropexy: success rates and complications. , 1996, American journal of obstetrics and gynecology.

[67]  L. Hughes,et al.  The outcomes of nonabsorbable mesh placed within the abdominal cavity: literature review and clinical experience. , 1998, Journal of the American College of Surgeons.

[68]  C. Chu,et al.  Characterization of morphologic and mechanical properties of surgical mesh fabrics. , 1985, Journal of biomedical materials research.

[69]  P. Culligan,et al.  Long-term success of abdominal sacral colpopexy using synthetic mesh. , 2002, American journal of obstetrics and gynecology.

[70]  F. Costa,et al.  The influence of differing pore sizes on the biocompatibility of two polypropylene meshes in the repair of abdominal defects , 2001, Hernia.

[71]  R. Condon,et al.  Double-layer prostheses for repair of abdominal wall defects in a rabbit model. , 1993, The Journal of surgical research.

[72]  J. Hiatt,et al.  Mature fibrous cyst formation after Marlex mesh ventral herniorrhaphy: a newly described pathologic entity. , 1993, The American surgeon.

[73]  G. Edwards,et al.  Evaluation of a collagen-based biosynthetic material for the repair of abdominal wall defects. , 1998, Journal of biomedical materials research.

[74]  H. Besim,et al.  Prevention of Intraabdominal Adhesions Produced by Polypropylene Mesh , 2002, European Surgical Research.

[75]  G. G. Kotia,et al.  Clinical experience with the silicone tracheal prosthesis. , 1990, The Journal of thoracic and cardiovascular surgery.

[76]  U Klinge,et al.  PVDF as a new polymer for the construction of surgical meshes. , 2002, Biomaterials.

[77]  U. Klinge,et al.  [Preperitoneal mesh-plasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias]. , 1996, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[78]  M. Neo,et al.  Repair of segmental long bone defect in rabbit femur using bioactive titanium cylindrical mesh cage. , 2003, Biomaterials.

[79]  T. Julian The efficacy of Marlex mesh in the repair of severe, recurrent vaginal prolapse of the anterior midvaginal wall. , 1996, American journal of obstetrics and gynecology.

[80]  J J Kuttenberger,et al.  Long-term results following reconstruction of craniofacial defects with titanium micro-mesh systems. , 2001, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[81]  A. M. Granda,et al.  Marlex mesh in repair of a diaphragmatic defect later eroding into the distal esophagus and stomach. , 1979, The American surgeon.

[82]  Z. Kaufman,et al.  Fecal fistula: A late complication of Marlex® mesh repair , 1981, Diseases of the colon and rectum.

[83]  R. Bleichrodt,et al.  Reherniation after repair of the abdominal wall with expanded polytetrafluoroethylene. , 1994, Journal of the American College of Surgeons.

[84]  R. Bothra Late onset small bowel fistula due to tantalum mesh. , 1973, American journal of surgery.

[85]  K. Ph,et al.  Suture resistance to infection. , 1982 .

[86]  J. Jeekel,et al.  An evaluation of risk factors in incisional hernia recurrence. , 1993, Surgery, gynecology & obstetrics.

[87]  R. Quester,et al.  Vypro II® Mesh in Hernia Repair: Impact of Polyglactin on Long-Term Incorporation in Rats , 2003, European Surgical Research.

[88]  T. Young,et al.  Studies on the effect of surface properties on the biocompatibility of polyurethane membranes. , 2001, Biomaterials.

[89]  H. Herbst,et al.  Effective prevention of adhesions with hyaluronate. , 2002, Archives of surgery.

[90]  J. Bellón,et al.  Tissue response to polypropylene meshes used in the repair of abdominal wall defects. , 1998, Biomaterials.

[91]  M. Dayton,et al.  Use of an absorbable mesh to repair contaminated abdominal-wall defects. , 1986, Archives of surgery.

[92]  Kalsbeek Hl,et al.  Recurrent inguinal hernia repaired with mesh (Teflon). , 1989 .

[93]  Y. Shimizu,et al.  Porous-type tracheal prosthesis sealed with collagen sponge. , 1997, The Annals of thoracic surgery.

[94]  M. Gray,et al.  Colovesical fistula after laparoscopic inguinal hernia repair , 1994, The British journal of surgery.

[95]  P. Goldstraw,et al.  Soft-tissue reconstruction in thoracic surgery. , 1995, The Annals of thoracic surgery.

[96]  J. Planell,et al.  Early imaging of integration response to polypropylene mesh in abdominal Wall by environmental scanning electron microscopy: Comparison of two placement techniques and correlation with tensiometric studies , 2001, World Journal of Surgery.

[97]  J. Richardson,et al.  Comparison of Prosthetic Materials for Abdominal Wall Reconstruction in the Presence of Contamination and Infection , 1985, Annals of surgery.

[98]  M. Manfrini,et al.  Sternal reconstruction with synthetic mesh and metallic plates for high grade tumours of the chest wall. , 2002, The European journal of surgery = Acta chirurgica.

[99]  A. Grant,et al.  Mesh compared with non‐mesh methods of open groin hernia repair: systematic review of randomized controlled trials , 2000 .

[100]  I. Nathan,et al.  A biomechanical study of the aponeurotic inguinal hernia repair. , 1994, Journal of the American College of Surgeons.

[101]  F. Puma,et al.  Chest wall stabilization with synthetic reabsorbable material. , 1992, The Annals of thoracic surgery.

[102]  M. Franklin,et al.  Preliminary experience with new bioactive prosthetic material for repair of hernias in infected fields , 2002, Hernia.

[103]  W. Limberg,et al.  [Pathophysiology of the abdominal wall]. , 1996, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[104]  K. Ogan,et al.  Antibacterial mesh sling: a prospective outcome analysis. , 2000, Urology.

[105]  W. Junger,et al.  Ileocutaneous fistula formation following laparoscopic polypropylene mesh hernia repair , 1997, Surgical Endoscopy.

[106]  D. Williams,et al.  Effects of physical configuration and chemical structure of suture materials on bacterial adhesion. A possible link to wound infection. , 1984, American journal of surgery.

[107]  Y Pouliquen,et al.  Novel synthetic meshwork for glaucoma treatment. I. Design and preliminary in vitro and in vivo evaluation of various expanded poly(tetrafluoroethylene) materials. , 1999, Journal of biomedical materials research.

[108]  Klamer Tw,et al.  A comparison of prosthetic materials used to repair abdominal wall defects. , 1983, Surgery.