Mesh terminology 101

Abstract

In any collaborative endeavor, when fields like medicine and bioengineering overlap, the proper use of technical vocabulary takes on added importance. It is important that scientists and clinicians, while coming from different backgrounds and educational systems, agree upon and utilize a common language based on mutually understood concepts and definitions. Regarding biomaterial testing applications, numerous terms are used to describe a wide variety of material behaviors when test specimens are subjected to mechanical, chemical, electrical and thermal stressors. In this discussion we will limit ourselves to the mechanical properties of materials which are utilized for soft tissue or fascial-based repairs. Following a literature search combining the keywords surgical mesh and biomaterials testing, common terms used to describe the mechanical properties of mesh were selected. Our analysis seeks to define the following terms and describe their applicability within the context of biomaterials for hernia repair: elasticity, stiffness, flexibility, tensile strength, distension, deformation, bending stiffness, and compliance. Unfortunately, in the technical literature, terms are often altered or extrapolated without adequate explanation. In other cases, related but technically different terms are mistakenly used interchangeably. With the mounting interest in biomaterials for the use in repair of abdominal wall defects, there is a need to standardize the terminology used to describe the biomechanical properties of mesh.

Elongation of textile pelvic floor implants under load is related to complete loss of effective porosity, thereby favoring incorporation in scar plates

“…Porosity has been identified to be decisive for proper tissue integration. 9,10 In small pores, the foreign body reaction bridges from one filament to the other and leads to pores completely filled with scar, whereas in structures with sufficiently large pores local physiologically regenerated tissue, for example, fat can be seen. Large pores with a diameter of more than 1000 mm for polypropylene or 600 mm for polyvinyl fluoride have been found to prevent the undesirable bridging of scar tissue throughout the pore.…”

The Prosthetic Materials in Hernia Repair

“…The polyethylene graft was first used by Dr. Francis Usher in 1958 (2,3). However, in this first use, sterilization problems were recorded for this material.…”

A lágyéktáji és hasfali sérvek laparoscopos műtétei – áttekintés

“…Előfordul, hogy a megfelelő porozitású háló fertőződését, sipolyozását a rögzítésére használt polyphil varróanyag okozza. 13 …”

“…De ha a háló -irritációja révén -a bélfalon fejti ki hatását, ami a háló műtéti típushoz nem igazodó kivá-lasztása vagy rossz elhelyezése következtében fordulhat elő, a nemkívánatos kitapadások, hegesedések, megtöreté-sek passage-zavart, sőt ileust okozhatnak. 13 …”

“…A nagy fokban zsugorodó hálódugó esetenként porchoz hasonló konzisztenciát vesz fel, kitapinthatóvá válik, elvándorol. 13 …”