Large pore size and controlled mesh elongation are relevant predictors for mesh integration quality and low shrinkage – Systematic analysis of key parameters of meshes in a novel minipig hernia model

Weyhe, Dirk; Cobb, William S.; Lecuivre, Julie; Alves, Antoine; Ladet, Sebastien; Lomanto, Davide; Bayon, Yves

doi:10.1016/j.ijsu.2015.07.717

Cited by 36 publications

(21 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, prevention of pore collapse to avoid bridging scars requires high structural load stability of the textile construction. 381 – 386 Plugs, when compared with flat meshes, have higher risks of extensive fibrosis and are more likely to stimulate an intense inflammatory reaction, thereby resulting in nonconforming biomechanical properties. 366 , 382 …”

Section: Meshesmentioning

confidence: 99%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,552

712

View full text Add to dashboard Cite

IntroductionWorldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery.MethodsAn expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores.Results and summaryThe risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment s...

show abstract

Section: Meshesmentioning

confidence: 99%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,552

712

View full text Add to dashboard Cite

show abstract

“…Once necrotic tissue has been fully debrided, negative pressure wound therapy can be used to encourage granulation formation through the mesh pores, ultimately covering the mesh [28] . In animal models, the degree and speed of tissue integration is greatest with macroporous (1.8 mm × 3.4 mm pore size) compared to microporous mesh (0.9 mm × 1 mm pore size) [29] . This is thought to be one of the contributing factors in the improved salvage rate of macroporous mesh [12] .…”

Section: Mesh Exposurementioning

confidence: 99%

Management of post-operative complications in open ventral hernia repair

O’Connor¹,

Carbonell²

2019

PAR

View full text Add to dashboard Cite

Hernia repair is the most common general surgical procedure performed in the United States; however, historically, there has been a surprising lack of consensus regarding hernia complications and their management. The development of international, prospectively-collected databases such as the Americas Hernia Society Quality Collaborative has introduced a new era of evidence-based practice around the prevention and management of these complications. This review seeks to equip surgeons with evidence-based techniques for prevention and management of the most common complications of open ventral hernia repair.

show abstract

“…From a previous pig experiment, in terms of mesh integration, shrinkage, and elongation, a synthetic large-pore mesh is suitable for large abdominal wall defects. 5 However, fascial closure is needed to avoid mesh from attaching directly to the intestine. A small-pore composite mesh can be set intraperitoneally; however, its infection rate is reported to be high (10.2%), even in clean wounds, and needs removal in most cases.…”

Section: Discussionmentioning

confidence: 99%

The Internal Oblique Muscle Flap with Synthetic Mesh Reinforcement for a Large, Contaminated Abdominal Wall Defect

Watanabe

Sakuma

Kono

et al. 2020

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary: We report a case of a large mediocaudal abdominal defect in contaminated circumstances with no residual rectus abdominis muscle that was reconstructed using an internal oblique muscle flap with large-pore polypropylene mesh reinforcement. The internal oblique muscle flap can reconstruct the lower abdominal midline without leaving any additional conspicuous scar. Previous studies showed that large-pore polypropylene mesh in contaminated wounds has a minimal difference in terms of infection rate, and less frequent occurrence of hernia, compared even with biological meshes. We believe that this method could be a strong and cosmetically satisfying option for large mediocaudal abdominal wall reconstruction.

show abstract

Large pore size and controlled mesh elongation are relevant predictors for mesh integration quality and low shrinkage – Systematic analysis of key parameters of meshes in a novel minipig hernia model

Cited by 36 publications

References 30 publications

International guidelines for groin hernia management

International guidelines for groin hernia management

Management of post-operative complications in open ventral hernia repair

The Internal Oblique Muscle Flap with Synthetic Mesh Reinforcement for a Large, Contaminated Abdominal Wall Defect

Contact Info

Product

Resources

About