In Vivo Evaluation of a Novel Mesh Suture Design for Abdominal Wall Closure

PURPOSE:To compare the inflammatory response of three different meshes on abdominal hernia repair in an experimental model of incisional hernia. METHODS:Median fascial incision and skin synthesis was performed on 30 Wistar rats. After 21 days, abdominal hernia developed was corrected as follows: 1) No mesh; 2) Polypropylene mesh; and, 3) Ultrapro ® mesh. After 21 days, the mesh and surrounding tissue were submitted to macroscopic (presence of adhesions, mesh retraction), microscopic analysis to identify and quantify the inflammatory and fibrotic response using a score based on a predefined scale of 0-3 degrees, evaluating infiltration of macrophages, giant cells, neutrophils and lymphocytes. RESULTS:No significant difference was seen among groups in adherences, fibrosis, giant cells, macrophages, neutrophils or lymphocytes (p>0.05). Mesh shrinkage was observed in all groups, but also no difference was observed between polypropylene and Ultrapro mesh (7.0±9.9 vs. 7.4±10.1, respectively, p=0.967). Post-operatory complications included fistula, abscess, dehiscence, serohematic collection and reherniation, but with no difference among groups (p=0.363). CONCLUSION:There is no difference between polypropylene (high-density) and Ultrapro ® (low-density) meshes at 21 days after surgery in extraperitoneal use in rats, comparing inflammatory response, mesh shortening, adhesions or complications.

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“…All groups still had presence of macrophages besides neutrophil infiltration, in contrast to other studies 15,16 .…”

Section: ®3contrasting

confidence: 50%

Polypropylene and polypropylene/polyglecaprone (Ultrapro(r)) meshes in the repair of incisional hernia in rats

Utiyama

Rosa²,

Andres³

et al. 2015

Acta Cir. Bras.

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“…One could propose that the three-dimensional, macroporous structure of the Duramesh™ would provide for a more profound tissue integration, allowing the tissue to grow through its individual threads and completely envelop the suture. This could hypothetically strengthen the wound healing and help prevent incisional hernia, something which has already been shown in in vivo experiments [8]. Finding a way to simulate wound healing, such as in animal models, would allow to focus on incisional hernia formation at a later point in time-after closure of the abdominal wall and during the healing process.…”

Section: Discussionmentioning

confidence: 93%

Evaluation of a new suture material (Duramesh™) by measuring suture tension in small and large bites techniques for laparotomy closure in a porcine model

Yurtkap

Hartog

Weteringen³

et al. 2020

Hernia

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Purpose After closure of laparotomies, sutures may pull through tissue due to too high intra-abdominal pressure or suture tension, resulting in burst abdomen and incisional hernia. The objective of this study was to measure the suture tension in small and large bites with a new suture material. Methods Closure of the linea alba was performed with small bites (i.e., 5 mm between two consecutive stitches and 5 mm distance from the incision) and large bites (i.e., 10 mm × 10 mm) with Duramesh™ size 0 (2 mm) and PDS II 2-0 in 24 experiments on six porcine abdominal walls. The abdominal wall was fixated on an artificial computer-controlled insufflatable abdomen, known as the 'AbdoMan'. A custom-made suture tension sensor was placed in the middle of the incision. Results The suture tension was significantly lower with the small bites technique and Duramesh™ when compared with large bites (small bites 0.12 N (IQR 0.07-0.19) vs. large bites 0.57 N (IQR 0.23-0.92), p < 0.025). This significant difference was also found in favour of the small bites with PDS II 2-0 (p < 0.038). No macroscopic tissue failure was seen during or after the experiments. Conclusion Closure of the abdominal wall with the small bites technique and Duramesh ™ was more efficient in dividing suture tension across the incision when compared to large bites. However, suture tension compared to a conventional suture material was not significantly different, contradicting an advantage of the new suture material in the prevention of burst abdomen and incisional hernia during the acute, postoperative phase. HerniaPublisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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“…Dumanian created a new mesh suture that is almost 10 times larger in diameter than a standard suture, but was designed to limit acute suture pull-through due to an improved distribution of forces at the suture-tissue interface. 41,42 Because much of the diameter of the mesh sutures is air between the filaments of the mesh, these filaments collapse at the knot to become smaller and more biocompatible. The walls of the suture are an open mesh so that tissue can grow into and surround the woven filaments as early as 8 days after placement.…”

Section: Closure Of the Abdominal Wall With Mesh-derived Suturesmentioning

confidence: 99%

Contemporary concepts in hernia prevention: Selected proceedings from the 2017 International Symposium on Prevention of Incisional Hernias

Harris

Hope

Adrales

et al. 2018

Surgery

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Incisional hernia is a frequent complication of midline laparotomy and enterostomal creation and is associated with high morbidity, decreased quality of life, and high costs. The International Symposium on Incisional Hernia Prevention was held October 19-20, 2017, at the InterContinental Hotel in San Francisco, CA, hosted by the Department of Surgery, University of California, San Francisco. One hundred and three attendees included general and plastic surgeons from 9 countries, including principal participants for several of the seminal studies in the field. Over the course of the 2-day meeting, there were 38 oral presentations, 3 keynote lectures, and 2 panel discussions. The Symposium was a combination of new information but also a comprehensive review of the existing data so as to assess the current state of the field and to set the stage for future research. Further, the Symposium sought to increase awareness and thus emphasize the importance of preventing the formation of incisional and enterostomal hernias.

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In Vivo Evaluation of a Novel Mesh Suture Design for Abdominal Wall Closure

Abstract: Supplemental Digital Content is available in the text.

Cited by 34 publications

References 36 publications

Polypropylene and polypropylene/polyglecaprone (Ultrapro(r)) meshes in the repair of incisional hernia in rats

Polypropylene and polypropylene/polyglecaprone (Ultrapro(r)) meshes in the repair of incisional hernia in rats

Evaluation of a new suture material (Duramesh™) by measuring suture tension in small and large bites techniques for laparotomy closure in a porcine model

Contemporary concepts in hernia prevention: Selected proceedings from the 2017 International Symposium on Prevention of Incisional Hernias

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