The incidence of adhesions and work and strength of adhesion separation are reduced when using a treated mesh, compared to the untreated mesh and the control group without mesh. Parietex Composite, Parietene Composite, Bard Composix E/X, and Gore-Tex Dual Mesh were superior to Sepramesh, untreated Parietene, and the control group in the prevention of adhesion formation.

Summary: The repair of inguinal or incisional hernias may occasionally require the placement of an intraabdominal mesh to reinforce parietal wall defects or weaknesses. An original composite mesh, consisting of a conventional polyester mesh combined with a coated hydrophilic and absorbable membrane designed to prevent intraperitoneal adhesions was evaluated. The efficacy of the product was tested through three experiments. The first carefully examined the absorption properties of the hydrophilic film as well as the biocompatibility of the patch after subcutaneous implantation. The second experiment was designed to evaluate adhesion formation in an animal model, comparing the mesh to two other commercially available membranes and to a control. In the third experiment, the product was tested in a porcine model. This was done in order to better evaluate the performance of the mesh in a model closer to human dimensions. These three experimental procedures demonstrated the biocompatibility of the membrane, the dramatically superior performance of the patch compared to other commercially available ones and to controls, and the validity of the concept in large animals. The composite mesh made of polyester and coated hydrogel fulfils the conditions for human evaluation.

CAPROSYN* suture is the latest innovation in monofilament synthetic suture. This suture is prepared from POLYGLYTONE*6211, a synthetic polyester composed of glycolide, caprolactone, trimethylene carbonate, and lactide. The purpose of this study was to compare the biomechanical performance of CAPROSYN* suture to that of CHROMIC GUT suture. The biomechanical performance studies included quantitative measurements of wound security, strength loss, mass loss, potentiation of infection, tissue drag, knot security, knot rundown, as well as suture stiffness. Both CAPROSYN* and CHROMIC GUT sutures provided comparable resistance to wound disruption. Prior to implantation, suture loops of CAPROSYN* had a significantly greater mean breaking strength than suture loops of CHROMIC GUT. Three weeks after implantation of these absorbable suture loops, the sutures had no appreciable strength. The rate of loss of suture mass of these two sutures was similar. As expected, CHROMIC GUT sutures potentiated significantly more infection than did the CAPROSYN* sutures. The handling properties of the CAPROSYN* sutures were far superior to those of the CHROMIC GUT sutures. The smooth surface of the CAPROSYN* sutures encountered lower drag forces than did the CHROMIC GUT sutures. Furthermore, it was much easier to reposition the CAPROSYN* knotted sutures than the knotted CHROMIC GUT sutures. In the case of CHROMIC GUT sutures, it was not possible to reposition a two-throw granny knot. These biomechanical performance studies demonstrated the superior performance of synthetic CAPROSYN* sutures compared to CHROMIC GUT sutures and provide compelling evidence of why CAPROSYN* sutures are an excellent alternative to CHROMIC GUT sutures.