Central rupture and bulging of low-weight polypropylene mesh following recurrent incisional sublay hernioplasty

Abstract

A recurrent incisional hernia resulting from the rupture of low-weight polypropylene mesh is rarely reported in the literature. Three patients with recurrent incisional hernia due to low-weight polypropylene mesh central rupture were operated 5, 7 and 13 months after initial sublay hernioplasty. The posterior myofascial layer was fully reconstructed in all patients during the hernioplasty, whereas the anterior myofascial layer was only partially reconstructed. The recurrent hernia was managed using heavy-weight polypropylene mesh; in two patients, a new sublay hernioplasty was performed and in one patient an "open preperitoneal flat mesh technique" was performed under local anaesthesia as a day case procedure. If closing of the anterior myofascial layer cannot be ensured during the incisional hernioplasty, the use of low-weight polypropylene meshes should be avoided; preference should be given to the heavy-weight polypropylene meshes.

Surgical mesh for ventral incisional hernia repairs:Understanding mesh design

“…The rationale for regarding weight as an independent variable from pore size is the hypothesis that lighter weight meshes will have a smaller foreign body burden (78) and a smaller biomaterial surface area (79) and, thus, should elicit a less intense foreign body reaction. Some studies confirm this effect in practice and claim that lower weight results in fewer complications, while others do not (63,80). Specific recommendations regarding the ideal mesh weight remain to be determined.…”

“…Most commercially available meshes exceed the required tensile strength to withstand the physiological forces of the abdominal wall (59). Nonetheless, mechanical failure of synthetic permanent mesh has been reported in the literature and appears to be exclusive to lightweight meshes (60)(61)(62)(63). Elasticity, compliance and stiffness are terms that are frequently confused or inaccurately used interchangeably.…”

“…Fundamentally, recurrence is caused by early degradation of the mesh, early removal of the mesh (as necessary following infections) or mesh failure ( Figure 5) (34,45,106). Mesh failure is caused by central mesh failure (mesh fracture) (60)(61)(62)(63) or fixation/suture line failure (107). Central mesh failure almost always occurs in lightweight but not heavyweight meshes (60)(61)(62)(63).…”

“…Mesh failure is caused by central mesh failure (mesh fracture) (60)(61)(62)(63) or fixation/suture line failure (107). Central mesh failure almost always occurs in lightweight but not heavyweight meshes (60)(61)(62)(63). Suture line failure is common and is typically reported as surgeon inexperience or fixation technique dependent.…”

Особенности Тканевой Реакции Брюшной Стенки На Имплантацию Легкого Усиленного Эндопротеза Для Герниопластики В Зависимости От Варианта Его Расположения

“…Для устранения описанных недостатков в клинической практике начали при-меняться легкие сетки с диаметром нити 90 мик-рон и суперлегкие с диаметром нити 70 мик-рон [2,9]. Недостатком этих сеток является низ-кая прочность изделия, которая при их импланта-ции в дефект апоневроза, превышающий 10 см 2 у больных с большими и гигантскими грыжами, может приводить к рецидиву заболевания [10,11].…”