Randomized Clinical Trial Comparing Low Density versus High Density Meshes in Patients with Bilateral Inguinal Hernia

Carro, José Luis Porrero; Riu, Sol Villar; Lojo, Beatriz Ramos; Latorre, Lucía; García, María Teresa Alonso; Pardo, Benito Alcaide; Naranjo, Oscar Bonachia; Herrero, Alberto Marcos; Cabezudo, Carlos Sánchez; Herreras, Esther Quiros

doi:10.1177/000313481708301217

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…One study used a polyester mesh (13) while the remaining 47 studies used meshes made of polypropylene. Nine of the studies used two meshes (48)(49)(50)(51)(52)(53)(54)(55)(56), resulting in 48 studies mentioning mesh weight for 57 meshes. Of these 58 meshes, 26 were by the authors defined as lightweight meshes (9-28, 50-55), 30 as heavyweight meshes , and one as a mediumweight mesh (56).…”

Section: Resultsmentioning

confidence: 99%

“…The pore size was reported in 13 studies (9-11, 14, 18, 20, 22, 23, 28, 50-53) (Figure 2B). Two studies described that the lightweight mesh had large pore size without specifying the size in mm (10,22), while the remaining ten studies either reported the pore diameter in mm or in µm, which was converted to mm (one study informed the size by email ( 23)) (9,11,14,18,20,23,(50)(51)(52)(53). Two studies had unspecified pore sizes (9,53) and two studies used a range (14,28).…”

Section: Lightweight Meshmentioning

confidence: 99%

“…The mesh size was reported in cm in 15 studies (9,13,14,17,19,20,21,23,25,26,28,(51)(52)(53)(54). There were many variations, which are presented in Table 1.…”

Section: Lightweight Meshmentioning

confidence: 99%

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Definition of Mesh Weight and Pore Size in Groin Hernia Repair: A Systematic Scoping Review of Randomised Controlled Trials

Deveci¹,

Öberg²,

Rosenberg³

2023

J. Abdom. Wall Surg.

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Introduction: Groin hernia literature often uses the terms light- and heavyweight and small or large pores to describe meshes. There is no universal definition of these terms, and the aim of this scoping review was to assess how mesh weight and pore sizes are defined in the groin hernia literature.Methods: In this systematic scoping review, we searched PubMed, Embase, and Cochrane CENTRAL. We included randomised controlled trials with adults undergoing groin hernia repair with the Lichtenstein or laparoscopic techniques using a flat permanent polypropylene or polyester mesh. Studies had to use the terms lightweight, mediumweight, or heavyweight to be included, and the outcome was to report how researchers defined these terms as well as pore sizes.Results: We included 48 studies with unique populations. The weight of lightweight meshes ranged from 28 to 60 g/m2 with a median of 39 g/m2, and the pore size ranged from 1.0 to 4.0 mm with a median of 1.6 mm. The weight of heavyweight meshes ranged from 72 to 116 g/m2 with a median of 88 g/m2, and the pore size ranged from 0.08 to 1.8 mm with a median of 1.0 mm. Only one mediumweight mesh was used weighing 55 g/m2 with a pore size of 0.75 mm.Conclusion: There seems to be a consensus that meshes weighing less than 60 g/m2 are defined as lightweight and meshes weighing more than 70 g/m2 are defined as heavyweight. The weight terms were used independently of pore sizes, which slightly overlapped between lightweight and heavyweight meshes.

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Section: Resultsmentioning

confidence: 99%

Section: Lightweight Meshmentioning

confidence: 99%

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Definition of Mesh Weight and Pore Size in Groin Hernia Repair: A Systematic Scoping Review of Randomised Controlled Trials

Deveci¹,

Öberg²,

Rosenberg³

2023

J. Abdom. Wall Surg.

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“… 22 However, Carro et al showed that no significant difference was between lightweight and heavyweight groups in terms of chronic pain. 23 In the study comparing TCM and PM, Koch et al showed that chronic pain was less in patients with TCM than in patients with PM. 6 Similar to previous studies, we observed lower chronic pain using TCM compared to PM.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes after Lichtenstein repair using titanium-coated mesh: A retrospective cohort study

Akalın

2020

Pak J Med Sci

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Objective: To examine the long-term outcomes such as recurrence, foreign body feeling and chronic pain of titanium-coated mesh (TCM) versus standard polypropylene mesh (PM) after Lichtenstein repair (LR). Methods: In this retrospective cohort study, patients who underwent TCM and PM in LR were evaluated between May 2014 and January 2018 at Ordu University Training and Research Hospital in Turkey. Primary outcomes (age, gender, body mass index, smoking habits, comorbid diseases, American Society of Anesthesiologists score, hernia type, side of hernia, duration of hernia presentation and operative time) and secondary outcomes (surgical site occurence, recurrence, foreign body feeling and chronic pain) were analyzed. Patients were divided into two groups according to the mesh elected (TCM and PM); titanium group (TG) and polypropylene group (PG), respectively. Results: In this study, 221 patients were analyzed; TCM was used in 72 (32.6%) patients and PM was used in 149 (67.4%) patients. No difference was found between groups in terms of primary outcomes (p>0.05). In the analysis of secondary outcomes, surgical site occurence was similar in both groups (p>0.05). Recurrence was observed in 1.39% (n=1) of TG and 2.01% (n=3) of PG. No difference was found between groups in terms of recurrence (p=0.606). Foreign body feeling was observed in 15.3% (n=11) of TG and 27.5% (n=41) of PG. Chronic pain was observed in 4.2% (n=3) of TG and 12.8% (n=9) of PG. Significant differences were found between groups in terms of chronic pain and foreign body feeling (p=0.046 and p=0.044, respectively). Conclusion: The result of this study shows that in LR, TCM leads to less foreign body feeling and chronic pain than PM. However, there was no difference in terms of recurrence between these meshes. doi: https://doi.org/10.12669/pjms.37.1.2694 How to cite this:Akalin C. Long-term outcomes after Lichtenstein repair using titanium-coated mesh: A retrospective cohort study. Pak J Med Sci. 2021;37(1):81-86. doi: https://doi.org/10.12669/pjms.37.1.2694 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Many investigations have demonstrated that patients using lightweight meshes present less foreign body sensation and discomfort after inguinal herniorrhaphy than those with heavy weight meshes. − Regarding acute and chronic pain, a survey by Carro et al revealed that there were remarkable differences in pain degree on the first and seventh days postoperatively. Lightweight meshes can effectively alleviate short-term pain.…”

Section: Strategies For Reducing Postoperative Complicationsmentioning

confidence: 99%

Latest Trends on the Attenuation of Systemic Foreign Body Response and Infectious Complications of Synthetic Hernia Meshes

Fang

Wang

et al. 2021

ACS Appl. Bio Mater.

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Throughout the past few years, hernia incidence has remained at a high level worldwide, with more than 20 million people requiring hernia surgery each year. Synthetic hernia meshes play an important role, providing a microenvironment that attracts and harbors host cells and acting as a permanent roadmap for intact abdominal wall reconstruction. Nevertheless, it is still inevitable to cause not-so-trivial complications, especially chronic pain and adhesion. In long-term studies, it was found that the complications are mainly caused by excessive fibrosis from the foreign body reaction (FBR) and infection resulting from bacterial colonization. For a thorough understanding of their complex mechanism and providing a richer background for mesh development, herein, we discuss different clinical mesh products and explore the interactions between their structure and complications. We further explored progress in reducing mesh complications to provide varied strategies that are informative and instructive for mesh modification in different research directions. We hope that this work will spur hernia mesh designers to step up their efforts to develop more practical and accessible meshes by improving the physical structure and chemical properties of meshes to combat the increasing risk of adhesions, infections, and inflammatory reactions. We conclude that further work is needed to solve this pressing problem, especially in the analysis and functionalization of mesh materials, provided of course that the initial performance of the mesh is guaranteed.

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Randomized Clinical Trial Comparing Low Density versus High Density Meshes in Patients with Bilateral Inguinal Hernia

Cited by 7 publications

References 21 publications

Definition of Mesh Weight and Pore Size in Groin Hernia Repair: A Systematic Scoping Review of Randomised Controlled Trials

Definition of Mesh Weight and Pore Size in Groin Hernia Repair: A Systematic Scoping Review of Randomised Controlled Trials

Long-term outcomes after Lichtenstein repair using titanium-coated mesh: A retrospective cohort study

Latest Trends on the Attenuation of Systemic Foreign Body Response and Infectious Complications of Synthetic Hernia Meshes

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