Roturas de malla: una causa poco frecuente de recidiva herniaria

Hernando, Luis Alberto Blázquez; Ureña, Miguel Ángel García; Monclús, Javier López; Lersundi, Álvaro Robin del Valle; Montes, Daniel; Cidoncha, Arturo Cruz; Ceinos, Carmen Jiménez; Pavón, Camilo Castellón

doi:10.1016/j.rehah.2015.02.006

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Regarding the computed response of the macroporus ultralight-weight SS mesh, this implant permitted greater displacements to those needed to mimic the natural distensibility of the abdomen. Despite the benefits associated to a light-weight (LW) or (ultralight-weight) ULW mesh in terms of foreign body reaction, infection risk or postoperative pain (Klosterhalfen et al, 2002;Brown and Finch, 2010;Li et al, 2012), this type of meshes are also frequently related to a higher risk of breakage (Lintin and Kingsnorth, 2014;Blázquez Hernando et al, 2015). Although additional mechanical tests should be performed to address breaking stretch and stress and properly determine the risk of breakage, based on the excessive elongation observed in this mesh the use of SS is not recommended for hernia repair.…”

Section: Discussionmentioning

confidence: 99%

Mechanical behavior of surgical meshes for abdominal wall repair: In vivo versus biaxial characterization

Simón-Allué

Ortillés

Calvo

2018

Journal of the Mechanical Behavior of Biomedical Materials

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Despite the widespread use of synthetic meshes in the surgical treatment of the hernia pathology, the election criteria of a suitable mesh for specific patient continues to be uncertain. Thus, in this work, we propose a methodology to determine in advance potential disadvantages on the use of certain meshes based on the patient-specific abdominal geometry and the mechanical features of the certain meshes. To that purpose, we have first characterized the mechanical behavior of four synthetic meshes through biaxial tests. Secondly, two of these meshes were implanted in several New Zealand rabbits with a total defect previously created on the center of the abdominal wall. After the surgical procedure, specimen were subjected to in vivo pneumoperitoneum tests to determine the immediate post-surgical response of those meshes after implanted in a healthy specimen. Experimental performance was recorded by a stereo rig with the aim of obtaining quantitative information about the pressure-displacement relation of the abdominal wall. Finally, following the procedure presented in prior works (Simón-Allué et al., 2015, 2017), a finite element model was reconstructed from the experimental measurements and tests were computationally reproduced for the healthy and herniated cases. Simulations were compared and validated with the in vivo behavior and results were given along the abdominal wall in terms of displacements, stresses and strain. Mechanical characterization of the meshes revealed Surgipro as the most rigid implant and Neomesh SuperSoft® as the softer, while other two meshes (Neomesh Soft®, Neopore®) remained in between. These two meshes were employed in the experimental study and resulted in similar effect in the abdominal wall cavity and both were close to the healthy case. Simulations confirmed this result while showed potential objections in the case of the other two meshes, due to high values in stresses or elongation that may led to discomfort in real tissue. The use of this methodology on human surgery may provide the surgeons with reliable and useful information to avoid certain meshes on specific-patient treatment.

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