Biomechanical Comparison of Abdominal Wall Hernia Repair Materials

Abstract

Complications following abdominal hernia repair include infection, mechanical failure, adhesion, and hernia recurrence [1,2]. Mesh materials require less revision surgery and reduce patient morbidity compared to when fascia is harvested [1,3]. Biologic meshes have lower infection rates and less adhesion than synthetic materials, but are more expensive [1]. In order to determine how these materials will function in vivo, it is important to simulate aspects of the actual conditions to which the material might be subjected after surgery. Previous studies have examined how different types of fascia, synthetic materials, and extracellular matrix materials responded to tests that mimic the in vivo state [3–6]. Suture retention testing has been used to compare the performance of human fascia versus possible substitutes [4]. Ball burst testing has been instrumental in understanding the biomechanical properties of different soft tissues and replacement materials by simulating biaxial forces associated with physiological loading conditions [5–7]. This objective of this was to determine which material might be most optimal for use in hernia repair. We hypothesize that biologic mesh materials will exhibit more optimal mechanical properties than synthetic materials when exposed to these test procedures.

Nonlinear and anisotropic tensile properties of graft materials used in soft tissue applications

“…Soft tissue grafts are available (or being developed) for a number of applications, yet there are few comprehensive, peer-reviewed, independent measures of their material properties. The majority of available studies are failure tests (Barber et al, 2006, Boguszewski, 2008, Coons and Alan Barber, 2006, Dejardin et al, 2001), which are relevant, but not a suitable indicator of physiological function. In this study, the degree of anisotropy and nonlinearity within each graft was evaluated, which provides critical functional parameters to be compared to the native tissue mechanics when selecting a graft for specific applications.…”