The use of prosthetic mesh for abdominal wall repairs: A semi‐systematic‐literature review

Wales, Emily; Holloway, Samantha

doi:10.1111/iwj.12977

Cited by 9 publications

(7 citation statements)

References 31 publications

(96 reference statements)

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“…The immune reaction due to mesh implantation may cause rejection long-term. However, the reason for rejection is largely unknown [25]. Elasticity HWM (elasticity 4-16%) when compared to LWM (Elasticity of 20-35%) may restrict the distension of the abdominal wall [26].…”

Section: Reactivity/biocompatibilitymentioning

confidence: 99%

A Narrative Review on Polypropylene Mesh Complications in Inguinal Hernia Repair - is Titanized Mesh an Option?

2022

J Surg

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Introduction: Since the introduction of mesh in Inguinal Hernia Repair (IHR) the recurrence rate was lowered. Instead, postoperative pain which may be related to mesh side effects e.g. fibrosis, foreign body reaction, erosion and migration, and infection, has been recognized as the relevant outcome factor. The long-term effects of mesh and composite mesh need to be analyzed.Methods: Pubmed, google scholar search using the search terms: polypropylene mesh, titanized mesh, TiMesh ® ; about polypropylene mesh the following terms: adhesion, erosion, infection, shrinkage, migration, seroma, degradation, pain; biocompatibility, foreign body reaction. Also, a bibliography of relevant articles and product-related information was searched.Results: Mesh properties are determined by tensile strength, pore size, weight, reactivity and biocompatibility, elasticity, constitution, and shrinkage. PolyPropylene Mesh (PP) is associated with actual and long-term complications more than expected. These complications are associated with mesh structure-lightweight meshes showed fewer risks for complication as infection, pain, mesh migration, foreign body response, erosion, adhesion, shrinkage, pain, seroma, and recurrence. TiMesh ® showed an advantage in in-vitro and animal studies which were supported by clinical studies. There is a shorter convalescence, and lesser foreign material sensitivity with comparable results in complications (Chronic pain, infection, recurrence). Conclusion:Polypropylene mesh has been successful in inguinal hernia repair for decades. However, in recent years complications of PP became evident in scientific reports and the public. Complications seem to be related to the material and structure of the mesh but also to the surgeon's expertise and patient's characteristics. It became evident that more complications appear long-term. The true rate of complications could be higher. There are a few clinical reports on titanium-coated mesh (TiMesh) in TAPP and TEP inguinal hernia repair. Experience with TiMesh in laparoscopic procedures long-term and open IHR are missing. Especially about the long-term effects of coating PP with titanium we need to have a better understanding of the interaction of soft tissue and mesh. There are promising results of pure titanium mesh for inguinal hernia repair which need to be confirmed in further controlled clinical studies.

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Section: Reactivity/biocompatibilitymentioning

confidence: 99%

A Narrative Review on Polypropylene Mesh Complications in Inguinal Hernia Repair - is Titanized Mesh an Option?

2022

J Surg

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“…In fact, mechanical strength and relatively long degradation rates are desirable properties for this type of surgical meshes. High mechanical strength is crucial to properly sustain the tissue, while moderate degradation rates are needed in order to give time to cells to populate the scaffold, produce new tissue while exerting at the same time the requested mechanical properties [42,96].…”

Section: Non-absorbable Synthetic Materialsmentioning

confidence: 99%

Next-generation surgical meshes for drug delivery and tissue engineering applications: materials, design and emerging manufacturing technologies

2021

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Surgical meshes have been employed in the management of a variety of pathological conditions including hernia, pelvic floor dysfunctions, periodontal guided bone regeneration, wound healing and more recently for breast plastic surgery after mastectomy. These common pathologies affect a wide portion of the worldwide population; therefore, an effective and enhanced treatment is crucial to ameliorate patients’ living conditions both from medical and aesthetic points of view. At present, non-absorbable synthetic polymers are the most widely used class of biomaterials for the manufacturing of mesh implants for hernia, pelvic floor dysfunctions and guided bone regeneration, with polypropylene and poly tetrafluoroethylene being the most common. Biological prostheses, such as surgical grafts, have been employed mainly for breast plastic surgery and wound healing applications. Despite the advantages of mesh implants to the treatment of these conditions, there are still many drawbacks, mainly related to the arising of a huge number of post-operative complications, among which infections are the most common. Developing a mesh that could appropriately integrate with the native tissue, promote its healing and constructive remodelling, is the key aim of ongoing research in the area of surgical mesh implants. To this end, the adoption of new biomaterials including absorbable and natural polymers, the use of drugs and advanced manufacturing technologies, such as 3D printing and electrospinning, are under investigation to address the previously mentioned challenges and improve the outcomes of future clinical practice. The aim of this work is to review the key advantages and disadvantages related to the use of surgical meshes, the main issues characterizing each clinical procedure and the future directions in terms of both novel manufacturing technologies and latest regulatory considerations. Graphic abstract

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“…This is because, despite technological and clinical advances, thus far it has not been possible to manufacture a single biomaterial with the precise characteristics needed to ensure optimal body-mesh matching and enhanced tissue repair while avoiding postsurgical complications or hernia recurrence. When selecting the best device to use, surgeons must consider multiple variables such as hernia type and its location, the patient's physiopathological condition, and the surgical procedure to be carried out [61]. Consequently, there is still much interest in developing advanced materials and meshes for hernia repair.…”

Section: Current Trends For Synthetic Meshesmentioning

confidence: 99%

New Insights into the Application of 3D-Printing Technology in Hernia Repair

et al. 2021

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Abdominal hernia repair using prosthetic materials is among the surgical interventions most widely performed worldwide. These materials, or meshes, are implanted to close the hernial defect, reinforcing the abdominal muscles and reestablishing mechanical functionality of the wall. Meshes for hernia repair are made of synthetic or biological materials exhibiting multiple shapes and configurations. Despite the myriad of devices currently marketed, the search for the ideal mesh continues as, thus far, no device offers optimal tissue repair and restored mechanical performance while minimizing postoperative complications. Additive manufacturing, or 3D-printing, has great potential for biomedical applications. Over the years, different biomaterials with advanced features have been successfully manufactured via 3D-printing for the repair of hard and soft tissues. This technological improvement is of high clinical relevance and paves the way to produce next-generation devices tailored to suit each individual patient. This review focuses on the state of the art and applications of 3D-printing technology for the manufacture of synthetic meshes. We highlight the latest approaches aimed at developing improved bioactive materials (e.g., optimizing antibacterial performance, drug release, or device opacity for contrast imaging). Challenges, limitations, and future perspectives are discussed, offering a comprehensive scenario for the applicability of 3D-printing in hernia repair.

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The use of prosthetic mesh for abdominal wall repairs: A semi‐systematic‐literature review

Cited by 9 publications

References 31 publications

A Narrative Review on Polypropylene Mesh Complications in Inguinal Hernia Repair - is Titanized Mesh an Option?

A Narrative Review on Polypropylene Mesh Complications in Inguinal Hernia Repair - is Titanized Mesh an Option?

Next-generation surgical meshes for drug delivery and tissue engineering applications: materials, design and emerging manufacturing technologies

New Insights into the Application of 3D-Printing Technology in Hernia Repair

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