Soft Tissue Anchoring Performance, Biomechanical Properties, and Tissue Reaction of a New Hernia Mesh Engineered to Address Hernia Occurrence and Recurrence.


Journal

Journal of medical devices
ISSN: 1932-6181
Titre abrégé: J Med Device
Pays: United States
ID NLM: 101299321

Informations de publication

Date de publication:
01 Dec 2019
Historique:
received: 27 12 2018
revised: 24 04 2019
entrez: 14 4 2020
pubmed: 14 4 2020
medline: 14 4 2020
Statut: ppublish

Résumé

One opportunity to reduce hernia occurrence and recurrence rates (currently estimated to be 30% at 10 years postoperatively) is by enhancing the ability of hernia meshes to anchor into tissue to prevent mesh migration, mesh contraction, and mesh tearing away from tissue. To address this, we developed a novel moderate-weight, macroporous, polypropylene mesh (termed the T-line mesh) with mesh extensions to optimize anchoring. We examined the physical properties, biomechanical performance, and biocompatibility of this novel mesh versus a predicate mesh anchored with #0-suture. The physical properties of the T-line mesh and predicate mesh were measured using American Society for Testing and Materials (ASTM) standards. Meshes were implanted into a swine hernia model and harvested after one day to determine anchoring strength of the meshes in the perioperative period. A separate group was implanted into a swine hernia model and harvested at 30 days and 90 days for semiquantitative histological analysis of biocompatibility. T-line mesh physical properties were similar to commonly used moderate-weight meshes in thickness and areal density. The T-line mesh outperformed the predicate mesh in all mechanical testing (P < 0.05). In the perioperative period, the T-line mesh was ∼275% stronger (P < 0.001) than the standard of care. Histological analysis of biocompatibility demonstrated no significant difference between the T-line mesh and predicate mesh (P > 0.05). The T-line mesh is a novel hernia mesh that outperforms a predicate mesh in mechanical and biomechanical performance testing while exhibiting similar biocompatibility. The T-line mesh has the potential to reduce hernia occurrence and recurrence caused by mechanical failure.

Identifiants

pubmed: 32280408
doi: 10.1115/1.4043740
pii: MED-18-1241
pmc: PMC7104760
doi:

Types de publication

Journal Article

Langues

eng

Pagination

0450021-450029

Informations de copyright

Copyright © 2019 by ASME.

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Auteurs

Mohamad M Ibrahim (MM)

Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, DUMC 3181, Durham, NC 27710.

Jason L Green (JL)

Duke University School of Medicine, 487 Medical Science Research Building 1, 203 Research Drive, Durham, NC 27710.

Jeffrey Everitt (J)

Department of Pathology, Duke University Medical Center, Durham, NC 27710.

David Ruppert (D)

Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710.

Richard Glisson (R)

Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710.

Frank Leopardi (F)

Department of Surgery, Duke University Medical Center, Durham, NC 27710.

Thomas Risoli (T)

Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710.

Maragatha Kuchibhatla (M)

Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710.

Randall Reynolds (R)

Division of Lab Animal Resources (DLAR), Duke University School of Medicine, Durham, NC 27710.

Howard Levinson (H)

Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710.

Classifications MeSH