Experimental biomechanical evaluation of polypropylene prostheses used in pelvic organ prolapse surgery

Sergent, F.; Désilles, Nicolas; Lacoume, Yann; Bunel, Claude; Marie, Jean‐Paul; Marpeau, L.

doi:10.1007/s00192-009-0825-x

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…After implantation, all materials will be subjected to cell interactions with the scaffolds and it has been suggested that PPL contracts by~15% after implantation [32,33]. Accordingly, we examined the extent of intrinsic contraction of the scaffolds both without and with cells and found that PLA and SIS both contracted by~15%.…”

Section: Discussionmentioning

confidence: 96%

Comparison of candidate scaffolds for tissue engineering for stress urinary incontinence and pelvic organ prolapse repair

et al. 2013

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Objectives• To identify candidate materials which have sufficient potential to be taken forward for an in vivo tissue-engineering approach to restoring the tissue structure of the pelvic floor in women with stress urinary incontinence (SUI) or pelvic organ prolapse (POP). Materials and Methods• Oral mucosal fibroblasts were seeded onto seven different scaffold materials, AlloDerm ( LifeCell Corp., Branchburg, NJ, USA), cadaveric dermis, porcine dermis, polypropylene, sheep forestomach, porcine small intestinal submucosa (SIS) and thermoannealed poly(L) lactic acid (PLA) under both free and restrained conditions. • The scaffolds were assessed for: cell attachment using AlamarBlue and 4,6-diamidino-2phenylindole (DAPI); contraction using serial photographs; and extracellular matrix production using Sirius red staining, immunostaining and scanning electron microscopy.• Finally the biomechanical properties of all the scaffolds were assessed. Results• Of the seven, there were two biodegradable scaffolds, synthetic PLA and natural SIS, which supported good cell attachment and proliferation.• Immunostaining confirmed the presence of collagen I, III and elastin which was highest in SIS and PLA.• The mechanical properties of PLA were closest to native tissue with an ultimate tensile strength of 0.72 Ϯ 0.18 MPa, ultimate tensile strain 0.53 Ϯ 0.16 and Young's modulus 4.5 Ϯ 2.9 MPa.• Scaffold restraint did not have a significant impact on the above properties in the best scaffolds. Conclusion• These data support both PLA and SIS as good candidate materials for use in making a tissue-engineered repair material for SUI or POP.

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Section: Discussionmentioning

confidence: 96%

Comparison of candidate scaffolds for tissue engineering for stress urinary incontinence and pelvic organ prolapse repair

et al. 2013

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“…Mesh shrinkage has been reported to occur early after tissue implantation, within the first 14 days of tissue healing in response to the acute inflammatory reaction [19]. After this early phase, mesh shrinkage defined as surface loss measured in millimeters and expressed as a percentage of initial surface area, and which occurs in 72% of all implants, was stable over a 180-day period in a rabbit abdominal model where it correspond to 3-20% of the initial surface area [19].…”

Section: Discussionmentioning

confidence: 99%

“…After this early phase, mesh shrinkage defined as surface loss measured in millimeters and expressed as a percentage of initial surface area, and which occurs in 72% of all implants, was stable over a 180-day period in a rabbit abdominal model where it correspond to 3-20% of the initial surface area [19].…”

Section: Discussionmentioning

confidence: 99%

Correlation between shrinkage and infection of implanted synthetic meshes using an animal model of mesh infection

et al. 2010

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Introduction and hypothesis The aim of this study was to evaluate a link between mesh infection and shrinkage. Methods Twenty-eight Wistar rats were implanted with synthetic meshes that were either non-absorbable (polypropylene (PP), n=14) or absorbable (poly (D,L-lactic acid) (PLA94), n=14). A validated animal incisionnal abdominal hernia model of mesh infection was used. Fourteen meshes (n=7 PLA94 and n=7 PP meshes) were infected intraoperatively with 10e6 CFU Escherichia coli, and compared with 14 non-infected meshes (n=7 PLA94 and n=7 PP meshes) (control groups). Explantations were performed on day 30. Shrinkage was evaluated by a reproducible numerical analysis of mesh area. Infection and histological study were evaluated on day 30.Results Non-infected meshes were less shrunk than infected meshes for both non-absorbable (5.0±1.7% versus 21.6±6.1%, p<0.05) and absorbable meshes (2.4±0.9% versus 11.0±2.5%, p<0.05). Conclusion This study highlights a link between infection and shrinkage in the model used.

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“…There is an increasing interest in the biomechanical properties of implants because they might be crucial for anatomical as well as functional outcome following sling surgeries for incontinence and mesh‐augmented prolapse repair 1 . Experimental studies investigating the deformation behaviour of materials both before and after implantation may contribute to a more evidence‐based choice of materials used clinically 2–6 . Outcome measures of such experiments include stress (or force), strain (or displacement), their relationship or compliance , and maximal force at disruption.…”

Section: Introductionmentioning

confidence: 99%

“…1 Experimental studies investigating the deformation behaviour of materials both before and after implantation may contribute to a more evidence-based choice of materials used clinically. [2][3][4][5][6] Outcome measures of such experiments include stress (or force), strain (or displacement), their relationship or compliance, and maximal force at disrup-tion. The focus in current implant design is on developing materials that are less stiff.…”

Section: Introductionmentioning

confidence: 99%

Persistence of polypropylene mesh anisotropy after implantation: an experimental study

Ozog

Konstantinovic

Werbrouck

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Please cite this paper as: Ozog Y, Konstantinovic M, Werbrouck E, De Ridder D, Mazza E, Deprest J. Persistence of polypropylene mesh anisotropy after implantation: an experimental study. BJOG 2011; DOI: 10.1111/j.1471‐0528.2011.03018.x. Objective To determine whether anisotropy persisted after incorporation into the host, using a standardised rabbit model for abdominal wall reconstruction. Design Investigator‐initiated prospective‐controlled experimental study. Setting Centre for Surgical Technologies, Medical Faculty KU‐Leuven. Sample Fifteen New Zealand White rabbits. Methods In each rabbit, four full thickness primarily repaired abdominal wall defects were covered by a 4 × 5‐cm Prolift+M implant (Johnson & Johnson, Norderstedt, Germany), either with the stiffest (n = 6 rabbits) or most elastic (n = 6) direction parallel to the body axis. Prolift+M contains 32 g/m2 polypropylene, reinforced with polyglecaprone fibres. Harvesting was performed after 30, 60 and 120 days (n = 2 each time‐point). The abdominal wall of three unoperated rabbits was used as negative control. Main outcome measures Contraction, compliance and maximal strain and stress determined by uniaxial tensiometry. Results Anisotropy properties persist at lower, more physiological displacements, but not at higher displacements. The stiffness of a mesh‐augmented repair in the lower strain range remains above that of native tissue. Eventual mesh contraction was limited to 4.3%. Conclusions Anisotropic properties of Prolift+M persist in vivo and shrinkage is minimal. Compliance of mesh‐augmented repair remains less than that of native tissue. The functional consequences of this remain to be studied.

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Experimental biomechanical evaluation of polypropylene prostheses used in pelvic organ prolapse surgery

Abstract: When the biomechanical parameters were comparatively assessed, HWPP was considered to have the most advantageous properties for prolapse surgery.

Cited by 13 publications

References 21 publications

Comparison of candidate scaffolds for tissue engineering for stress urinary incontinence and pelvic organ prolapse repair

Comparison of candidate scaffolds for tissue engineering for stress urinary incontinence and pelvic organ prolapse repair

Correlation between shrinkage and infection of implanted synthetic meshes using an animal model of mesh infection

Persistence of polypropylene mesh anisotropy after implantation: an experimental study

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