Modifying hernia mesh design to improve device mechanical performance and promote tension-free repair

Ibrahim, Mohamed M.; Poveromo, Luke; Glisson, Richard R.; Cornejo, Agustin; Farjat, Alfredo E.; Gall, Ken; Levinson, Howard

doi:10.1016/j.jbiomech.2018.01.022

Cited by 15 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As these locations have high stress concentrations within the material, they tend to be more reactive than the areas where fibers are relaxed. This elucidates why modifying knit design can improve mesh mechanical performance, such as in the study mentioned in the introduction [11].…”

Section: Discussionmentioning

confidence: 69%

“…These include alterations in a pore size and shape, transition from a heavyweight to a lightweight mesh, knitting design of the fibers, etc. Levinson et al showed that modifying the knits in the mesh significantly improves device mechanical performance and enhances tension-free repair [11]. Lightweight mesh has been reported to induce fewer peritoneal adhesions than a heavyweight mesh does [12].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Anti-inflammatory coating of hernia repair meshes: a 5-rabbit study

Bredikhin

Gil

Rex

et al. 2020

Hernia

View full text Add to dashboard Cite

Purpose Polymeric mesh implantation has become the golden standard in hernia repair, which nowadays is one of the most frequently performed surgeries in the world. However, many biocompatibility issues remain to be a concern for hernioplasty, with chronic pain being the most notable post-operative complication. Oxidative stress appears to be a major factor in the development of those complications. Lack of material inertness in vivo and oxidative environment formed by inflammatory cells result in both mesh deterioration and slowed healing process. In a pilot in vivo study, we prepared and characterized polypropylene hernia meshes with vitamin E (α-tocopherol)-a potent antioxidant. The results of that study supported the use of vitamin E as potential coating to alleviate post-surgical inflammation, but the pilot nature of the study yielded limited statistical data. The purpose of this study was to verify the observed trend of the pilot study statistically. Methods In this work, we conducted a 5-animal experiment where we have implanted vitamin E-coated and uncoated control meshes into the abdominal walls of rabbits. Histology of the mesh-adjacent tissues and electron microscopy of the explanted mesh surface were conducted to characterize host tissue response to the implanted meshes. Results As expected, modified meshes exhibited reduced foreign body reaction, as evidenced by histological scores for fatty infiltrates, macrophages, neovascularization, and collagen organization, as well as by the surface deterioration of the meshes. Conclusion In conclusion, results indicate that vitamin E coating reduces inflammatory response following hernioplasty and protects mesh material from oxidative deterioration.

show abstract

Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Anti-inflammatory coating of hernia repair meshes: a 5-rabbit study

Bredikhin

Gil

Rex

et al. 2020

Hernia

View full text Add to dashboard Cite

show abstract

“…Ibrahim et al. designed a novel anchorage-knotting system for the mesh with an increased extension anchor area to reduce tension experienced at the anchor point, leading to decreased risk of rupture at the interface . In the analysis of a porcine abdominal wall model, the modified mesh was 2-fold stronger than the conventional mesh in terms of resisting suture tearing and maintained anchoring at stresses exceeding clinically relevant benchmarks, decreasing tension at the local suture sites.…”

Section: Functional Meshesmentioning

confidence: 99%

Functionalized Strategies and Mechanisms of the Emerging Mesh for Abdominal Wall Repair and Regeneration

Liu

Wei

2021

ACS Biomater. Sci. Eng.

View full text Add to dashboard Cite

Meshes have been the overwhelmingly popular choice for the repair of abdominal wall defects to retrieve the bodily integrity of musculofascial layer. Broadly, they are classified into synthetic, biological and composite mesh based on their mechanical and biocompatible features. With the development of anatomical repair techniques and the increasing requirements of constructive remodeling, however, none of these options satisfactorily manages the conditional repair. In both preclinical and clinical studies, materials/agents equipped with distinct functions have been characterized and applied to improve meshaided repair, with the importance of mesh functionalization being highlighted. However, limited information exists on systemic comparisons of the underlying mechanisms with respect to functionalized strategies, which are fundamental throughout repair and regeneration. Herein, we address this topic and summarize the current literature by subdividing common functions of the mesh into biomechanics-matched, macrophage-mediated, integrationenhanced, anti-infective and antiadhesive characteristics for a comprehensive overview. In particular, we elaborate their effects separately with respect to host response and integration and discuss their respective advances, challenges and future directions toward a clinical alternative. From the vastly different approaches, we provide insight into the mechanisms involved and offer suggestions for personalized modifications of these emerging meshes.

show abstract

“… Physical properties [ 97 , 98 ] Risk of hernia recurrence due to insufficient mechanical properties. Appearance, physical dimensions (thickness) [ 23 ], monofilament diameter [ 22 ], pore properties [ 23 , 99 ] (pore size, pore density, porosity), weight per unit area/Density [ 23 , [100] , [101] , [102] ], uniaxial tensile strength [ 23 , 100 , [103] , [104] , [105] , [106] ], tensile elongation [ 106 , 107 ], burst strength [ 23 , 100 , 104 ], suture retention [ 23 , 100 , 104 ], suture pullout strength [ 108 ], connection strength between components and layers (when applicable), tear resistance [ 23 , 100 , 104 ] (when applicable), fading test (when applicable), stiffness [ 109 ]. Chemical properties Toxic reaction due to chemical residues.…”

Section: Current Statusmentioning

confidence: 99%

Regulatory science for hernia mesh: Current status and future perspectives

Liu

Xie

Zheng

et al. 2021

Bioactive Materials

View full text Add to dashboard Cite

Regulatory science for medical devices aims to develop new tools, standards and approaches to assess the safety, effectiveness, quality and performance of medical devices. In the field of biomaterials, hernia mesh is a class of implants that have been successfully translated to clinical applications. With a focus on hernia mesh and its regulatory science system, this paper collected and reviewed information on hernia mesh products and biomaterials in both Chinese and American markets. The current development of regulatory science for hernia mesh, including its regulations, standards, guidance documents and classification, and the scientific evaluation of its safety and effectiveness was first reported. Then the research prospect of regulatory science for hernia mesh was discussed. New methods for the preclinical animal study and new tools for the evaluation of the safety and effectiveness of hernia mesh, such as computational modeling, big data platform and evidence-based research, were assessed. By taking the regulatory science of hernia mesh as a case study, this review provided a research basis for developing a regulatory science system of implantable medical devices, furthering the systematic evaluation of the safety and effectiveness of medical devices for better regulatory decision-making. This was the first article reviewing the regulatory science of hernia mesh and biomaterial-based implants. It also proposed and explained the concepts of evidence-based regulatory science and technical review for the first time.

show abstract

Modifying hernia mesh design to improve device mechanical performance and promote tension-free repair

Cited by 15 publications

References 38 publications

Anti-inflammatory coating of hernia repair meshes: a 5-rabbit study

Anti-inflammatory coating of hernia repair meshes: a 5-rabbit study

Functionalized Strategies and Mechanisms of the Emerging Mesh for Abdominal Wall Repair and Regeneration

Regulatory science for hernia mesh: Current status and future perspectives

Contact Info

Product

Resources

About