The Use of Mersilene® Mesh in Repair of Abdominal Wall Hernias

Abstract

Use of synthetic materials in herniplasty has been a controversial issue. In order to determine the influence of Mersilene mesh on the strength of healing abdominal wounds and its effectiveness in repair of hernia, experimental and clinical studies were undertaken. Experimental study included 175 male rats divided into three groups subjected to either: 1) an incision made only through the skin and closed with 3-0 silk sutures; 2) a 2.5 cm midline incision through the musculature and peritoneum closed with 2-0 Mersilene suture; or 3) the same procedure as group 2 with the addition of a Mersilene mesh onlay graft. Bursting strength of abdominal wounds as determined in all groups at intervals. Wounds of the group treated with the mesh exhibited significantly greater (P less than 0.01) bursting strength. Clinical trial consisted of 100 consecutive adult patients in which an onlay graft of Mersilene mesh was used in the hernioplasty. Mesh was used as an adjunct in patients with: 1) large ventral hernias; 2) direct hernias resulting from severely attenuated transversialis fascia; 3) indirect hernias associated with a large internal ring and a weak posterior inguinal wall; or 4) combined direct and indirect hernias. All were followed for a minimum of one year to determine the incidence of complication and rate of recurrence. This study suggests that: 1) Mersilene mesh increases the strength of healing abdominal wounds in rats; and 2) repair of large hernias with Mersilene mesh results in an acceptable morbidity and a lowered rate of recurrence.

<i>In vivo </i>Exploration of the Tensile Strength of the Abdominal Wall after Repair with Different Prosthetic Materials

“…Although our findings corroborate previous reports that late in healing a wound is stronger than the nonrepaired abdominal wall (1,7,10), striking differences in the resistance of the abdominal wall were observed early on in healing using the different prostheses. During this period, disruption of the wound occurred quite readily and was generally located at the junction between the prosthesis and the parietes.…”

“…1) different from those previously described (7,8). After a skin incision to expose the prosthetic implant, the peritoneal cavity was filled with sterile water and methyl blue through a fine needle inserted into the anterior abdominal wall and secured by use of acrylate (Histoacryl, Braun Mensungen).…”

Omentum prevents intestinal adhesions to mesh graft in abdominal infections and serosal defects

“…In this study, Wistar albino rats were preferred because they had been used in previous similar studies investigating meshes [12,26,27,34,36]. …”

Biostability, Inflammatory Response, and Healing Characteristics of a Fluoropassivated Polyester‐Knit Mesh in the Repair of Experimental Abdominal Hernias

“…Various types of materials have been used for recurrent hernia repair, including metal meshes knitted from tantalum or stainless steel (16), solid or microporous plastic membranes such as silicone rubber (17) and expanded polytetrafluoroethylene (ePTFE) (18), and textile meshes made either from bioresorbable polymers such as polyglycolic acid (PGA) and polyglycolide‐lactide (PGLA) (8) or nonresorbable polymers such as polyester (19), nylon (20), polypropylene (21), and even carbon (22). After reviewing the literature on the various synthetic biomaterials for hernia repair, there is currently no single polymer or structure proven to combine optimal short‐ and long‐term healing performance and superior biostability.…”