Synthetic Implants in Hernia Surgery

Abstract

Abdominal wall hernia correction is one of the most common surgical procedures. 85,000 hernia operations are performed in Poland each year. Modern techniques of abdominal wall reconstruction utilize surgical implants for fascial defect closure. In the 70s and the 80s of the last century, these techniques gained widespread acceptance among surgeons. Significant improvement of results in terms of recurrences was observed. Treatment of large abdominal wall defects became possible. Three types of surgical implants were developed early: polipropylene (PP), poliethylene (PE) and politetrafluoroethylene (PTfE). Unfortunately, negative effects of implanted material soon became apparent. Excessive native tissues inflammatory response to the implanted material, leading to multiple complications was observed. Recurrences due to fibrosis, chronic regional pain, stiffness of the operation site, intestinal adhesions and fistulas, infertility and infections were reported. In some cases the use of standard synthetic implant was contraindicated. Analyzing drawbacks of the standard hernia implants, the medical industry developed new materials to improve treatment results. The most popular, currently utilized synthetic materials, are presented in this review in the context of clinical results (Adv Clin Exp Med 2014, 23, 1, 135-142).

Bridging repair of the abdominal wall in a rat experimental model. Comparison between uncoated and polyethylene oxide-coated equine pericardium meshes

“…However, higher incidence of recurrence was observed in Group A. These results are consistent with the hypothesis that PEO coating, conferring to the equine pericardium resistance to biodegradation, reduces the occurrence of incisional hernias, but on the other hand increases the risk of adhesions, as already proved in case of non-absorbable materials implanted into peritoneal cavity 42 . In Group B a liability to septic complications was observed, although no significant differences appeared in comparison with Group A.…”

Regenerating Critical Size Rat Segmental Bone Defects with a Self‐Healing Hybrid Nanocomposite Hydrogel: Effect of Bone Condition and BMP‐2 Incorporation

“…The strong bond of the carbon‐fluorine gives PTFE the durable properties, inertness, and resistance to chemical, biological and physical degradation. [ 25 ] PTFE as s biomaterial has been widely used in clinics for several years, [ 26–35 ] and is generally considered to be a well‐tolerated material and useful when autologous tissue is not available. One major drawback is the risk of infection.…”

Isatin thiosemicarbazone-blended polymer films for biomedical applications: surface morphology, characterisation and preliminary biological assessment

“…5 Several polymers are already being used in biomedical settings such as polyurethane (PU) for ureteral catheters, 2 poly(methyl methacrylate) (PMMA) 6 for bone glue and polytetrauoroethylene (PTFE) for vascular gras 7 or hernia repair. 8 Most of the reported studies rely on neat polymer molecules, however, by 'blending' in pharmacologically active compounds into the polymers, surface modications might be achieved affecting not only the biocompatibility, chemical or structural properties but also pathogen susceptibility, cell growth and cell metabolism.…”