Journal Article

Physicomechanical evaluation of absorbable and nonabsorbable barrier composite meshes for laparoscopic ventral hernia repair

Deeken, Corey R., Abdo, Michael S., Frisella, Margaret M., Matthews, Brent D.

2011

Overview

Background This study aimed to compare the physicomechanical properties of composite prostheses for laparoscopic ventral hernia repair (LVHR) through standard testing and a proposed classification system. Methods Seven prostheses (four with absorbable barriers and 3 with nonabsorbable barriers) were evaluated. The barrier layer was removed, after which the area of the interstices and the diameter of the filaments were determined. The barrier layer was left intact during thickness, density, suture retention strength, tear resistance, uniaxial tensile, and ball-burst testing. Specimens were oriented parallel or perpendicular to their longest dimension during testing. One-way analysis of variance (ANOVA) with Tukey’s posttest or an unpaired, two-tailed t -test was performed to determine whether differences existed due to mesh or orientation, and a p value <0.05 was considered significant. Results Significant differences were observed between mesh types and due to the orientation of the mesh during testing. Of the absorbable barrier meshes, Bard Sepramesh IP Composite demonstrated the greatest suture retention and tear strengths, followed by C-QUR mesh. Of the permanent barrier meshes, DUALMESH demonstrated the greatest suture retention strength in the perpendicular direction, followed by Bard Composix E/X. DUALMESH and Bard Composix E/X demonstrated equivalent suture retention strength in the parallel direction and equivalent tear resistance in both testing directions. All meshes demonstrated tensile strengths greater than the physiologically relevant range of 16–32 N/cm. Conclusions This study provided a basic understanding of how the structural aspects of each mesh design influence functionality. Differences between composite barrier prostheses commonly used for LVHR were observed due to barrier type, mesh type, and orientation. A set of standard testing techniques and a classification system also were presented to define fully the properties of these materials.

• Publisher: Springer-Verlag,Springer,Springer Nature B.V
• Subject: Abdominal Surgery / Absorbable Implants / Adhesion / Biological and medical sciences / Biomechanics / Composite materials / Densitometry / Digestive system. Abdomen / Endoscopy / Gastroenterology / Gynecology / Hepatology / Hernia, Ventral - surgery / Hernias / Humans / In Vitro Techniques / Investigative techniques, diagnostic techniques (general aspects) / Laparoscopy / Materials Testing / Mechanical properties / Medical sciences / Medicine / Medicine & Public Health / Proctology / Prostheses / Retention / Surgeons / Surgery / Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases / Surgical Mesh / Sutures / Technology. Biomaterials. Equipments / Tensile Strength / Textiles / Variance analysis