Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_753_Библиотеки_им_академика_М_И_Перельмана.pdf
6 Materials, Devices andGadgets forHernia Surgery
)
®
61
(Proxy Biomedical)
®
(Solvay)
Mesh (Gore
®
®
Mesh (Braun)
®
(Ethicon)
®
(Syneture)
®
Omyra
cPTFE mesh MotifMESH
PTFE Monolament macroporous INFINIT
Polyglycolic acid Dexon
PVDF mesh Co-PVDF
Mesh (Braun)
®
Sal
Absorbable Polyglactin 910 Vicryl
62
D. L. Sanders et al.
Table 6.6 Commonly used commercially available meshes (composite meshes)
Composite meshes Aim Additional component Mesh and manufacturer
®
PPM composites Improved physiological
function
Poliglecaprone 25 Ultrapro
Polyglactin 910 Vypro
(Ethicon)
®
/Vypro II® (Ethicon)—
Vypro = 69% PPM, 31%
Vicryl; Vypro II= 50% PPM,
50%Vicryl
Improved physiological
function/reduced
Poliglecaprone 25 +
polydioxanone
Physiomesh
®
(Ethicon)
adhesions
Reduced adhesions Collagen-oxidized lm Parietene Composite
(Sofradim)
ePTFE Bard
®
Composix® L/P (Bard)
®
Composix® E/X mesh
Bard
(Bard)
®
(Hernimesh®)
®
T1 (Cousin)
®
(Ethicon)
Hydrogel (polyvinylpyrrolidone +
polyethylene glycol)
Oxidized regenerated cellulose +
Relimesh
Intramesh
Adhesix (Cousin)—sutureless
Proceed
polydioxanone
PVDF DynaMesh
Sepralm
®
Sepramesh
®
(DynaMesh)
®
(Bard)
(carboxymethylcellulose and
hyaluronic acid)
Polyester mesh
composites
Reduced adhesions Collagen-oxidized lm Parietex Composite™/Parietex
Optimized Composite™
(Covidien™)
Dimethylsiloxane Biomesh
®
A2 (Cousin)—macroporous
Intramesh
®
W3 (Cousin)—microporous
®
Others Long-term absorbability
(up to 60weeks)
First bre = glycolide, lactide and
trimethylene carbonate
Tigr
Matrix (Novus
Scientic)
Second bre = lactide and
trimethylene carbonate
Encourages type 1
collagen
Polyglycolic acid + trimethylene
carbonate
Reduced adhesions Bovine gastric submucosa +
®
Bio-A
(Gore®)
Ovitex, Ovitex 1S, Ovitex 2S
polypropylene or polyglycolic
acid
Prevents ingrowth on the
visceral side
PTFE + polyglycolic acid/
trimethylene carbonate
Porcine small intestinal mucosa +
Synecor
Zenapro
polypropylene
®
6.3.2 Fixation Methods
6.3.2.1 Suture Fixation
Since the introduction of plastic hernia meshes in
the 1950s, sutures have been the most commonly
used method for mesh xation in open hernia surgery. As a result, suture xation is often used as
the control in studies assessing other xation
methods [156–158, 168–190]. The suture vari-
ables that exist are related to the suture material
used, the suture technique (interrupted vs. continuous), the bite size, the bite placement (in relation to the edge of the mesh and abdominal wall)
and the distance between sutures.
Suture Material
Suture material adds to the prosthetic load in hernia surgery, and this may have an impact on the
ab
6 Materials, Devices andGadgets forHernia Surgery
Table 6.7 Commonly used commercially available meshes (biological meshes)
Biological meshes Mesh and manufacturer
Porcine small intestinal submucosa Non-cross-linked Surgisis
Cross-linked Fortagen
Human acellular dermis Non-cross-linked AlloDerm
®
(Cook)
®
(Organogenesis)
®
(LifeCell)
AlloMax (Bard)
®
Flex HD
Xenogenic acellular dermis Non-cross-linked Strattice
Veritas
SurgiMend
Tutomesh
(Ethicon)
®
(LifeCell)
®
(Synovis)
®
(TEI Biosciences)
®
(RTI Bilogics)
XenMatrix (Brennen)
Peri-Guard
®
(Synovis)
Cross-linked Permacol™ (Covidien™)
®
CollaMend
(Bard)
63
c d
Fig. 6.9 Low-power electron microscopy demonstrating
the ultrastructure of polyethylene mosquito net compared
to the commercial meshes analysed (JEOL scanning elec-
tron microscope 925 original magnication). (a)
Polyethylene mosquito net, (b) ProleneÒ, (c) BardÒ
mesh, (d) VyproÒ, (e) UltraProÒ, (f) Parietex [189]
64
e f
Fig. 6.9 (continued)
D. L. Sanders et al.
rate of mesh infection as well as surgical site
infection, which is an important factor contributing to hernia recurrence in addition to morbidity
and the costs.
It has been recommended (level of evidence,
2C) to use monolament non-absorbable or longterm absorbable sutures in mesh xation. In 2011
a Swedish retrospective review of 82,015 patients
concluded that the risk of hernia recurrence following Lichtenstein open inguinal hernia repair is
more than double when short-term absorbable
sutures were used in mesh xation compared to
non-absorbable and long-term absorbable sutures
(RR 2.23, 95% CI 1.67–2.99, p<0.01) [191]. This
review was supported by an animal model study
comparing polypropylene and polyglactin 910
sutures. At 8weeks, mesh xation was found to be
signicantly greater with polypropylene sutures
compared to polyglactin 910 sutures [156].
On the other hand, in 2002 a single surgeon
qRCT performed by Paajanen comparing polypropylene and Dexon™ (Syneture) sutures in
mesh xation in 162 inguinal hernia repairs concluded that there is no difference in terms of
recurrence, pain or infection with a mean followup of 2years [183].
In assessment of bacterial adherence to
suture material, invitro studies have concluded
that there is a signicantly high rate of bacterial
adherence to the suture material when absorbable braided sutures are used for mesh xation
[166, 192]. In order to overcome this problem,
sutures have been treated with antibacterial
coating. In vitro and animal model settings
have shown that sutures treated with triclosan
appear to reduce bacterial adhesion and viability [167, 186].
The choice of suture material does not appear
to affect chronic pain, adhesion formation or
operative time [156, 183, 191, 193]. There is no
evidence to support a particular gauge of suture
material over another or one suture needle in
preference to another.
In comparison with other xation techniques,
several studies have concluded that suture xation results in stronger mesh xation strength
compared to tacks or glue [155, 170, 188, 193,
194]. However the clinical signicance of this is
unclear since the majority of studies comparing
suture xation with tacks, brin sealant or glue
show no difference in recurrence rates between
the groups [168, 172, 173, 180–182]. In a rat
model, Karatepe etal. found that in a contaminated surgical eld, infection rates were higher
when the mesh was xed with suture material
compared to glue [178].
6 Materials, Devices andGadgets forHernia Surgery
65
Suture Technique
The technique used for xing the mesh with
sutures depends on the type of the hernia and the
mesh position. It is recommended (level of evidence: 5) to avoid bridging the hernia defect with
mesh in open hernia surgery. In vitro biomechanical inguinal hernia models have concluded that a
closed hernia defect requires signicantly greater
bursting pressure compared to a bridged defect
[158]. In the assessment of continuous vs. interrupted sutures used in mesh xation, Sekmen
et al. have concluded that mesh contraction is
lower in the continuous group in rat model [185].
In laparo-endoscopic surgery for inguinal and
incisional hernias, it was found that most studies
were assessing the use of transabdominal suture
technique in mesh xation with no studies assessing xation using laparo-endoscopic suturing
technique [156, 177, 179, 188, 194–197].
When performing suture xation, it is widely
agreed that transfascial sutures are the gold standard technique. This said, a systematic review of
6,016 patients undergoing laparo-endoscopic
repair of incisional hernias concluded that there
is a signicantly higher rate of surgical site infection in suture xation [198]. They found no signicant difference in recurrence or chronic pain
between the two groups.
van’t Riet et al. concluded that the optimal
distance between transabdominal sutures for xation of mesh in laparo-endoscopic ventral hernia
repair was 1.8cm. The study assessed the strength
of mesh xation using a porcine model without
considering the size of the defect and the type of
the mesh used in the repair [188]; however, there
is enough data to support these ndings.
6.3.2.2 Glue Fixation
Surgical glue was originally used during the
Vietnam War for traumatic wound closure. Its
use in hernia surgery was rst described by
Farouk etal. in 1996 [199]. It is a synthetic cyanoacrylate-based compound that works by contact-induced exothermic hydroxylation of the
monomer to form a stable polymer. In order to
assess the use of glue in mesh xation, several
studies have been conducted. Using an animal
model, glue was found to be inferior to sutures,
tacks [194] or staples [170] in terms of xation
strength. However these ndings were opposed
by other studies that found no difference between
glue and sutures [172, 200]. In the assessment of
hernia recurrence following open inguinal hernia
repair, there are comparable recurrence rates
with glue xation compared to other xation
methods (level of evidence: 1B). Several studies
have concluded that there is no difference
between glue xation compared to either suture
or brin sealant xation [168, 172, 173, 176,
182, 201, 202]. In the assessment of acute and
chronic postoperative pain, there are lower rates
of chronic pain with glue xation compared to
suture xation in open inguinal hernia repair
(level of evidence, 2B). A RCT has concluded
that postoperative pain scores and analgesia
requirements were lower in the glue group compared to suture group on the rst postoperative
day [182]. Also, the incidence of chronic pain
was less in the glue group (0% vs. 3.39%) [176,
202]. In contrast, another RCT reported no dif-
ference in acute or chronic pain between glue
and suture xation (20.1% vs. 15.5%, P=0.318)
[168, 173, 201]. In comparison with suture xation in open inguinal hernia repair, the glue xation showed no difference in terms of wound
infection rates (3.3% vs. 1.3%, P=0.448) [173,
201]. However, using an animal model, it was
found that there are lower bacterial adherence
rates with glue xation compared to suture xation following hernia repair in the presence of
infection [178]. In the assessment of operative
time, Bar etal. reported a shorter operative time
with glue compared to sutures [168], yet
Nowobilski reported no difference in terms of
cost or length of hospital stay [182]. This nding
was supported by Pagane etal. [201]; however,
there is insufcient evidence to support these
ndings.
6.3.2.3 Fibrin Sealant Fixation
Fibrin sealants are biological glues that work by
reproducing the nal steps of the coagulation
cascade. They involve simultaneous application
of concentrated human brinogen and lyophi-
66
D. L. Sanders et al.
lized factor XIII that is reconstituted with aprotinin (antibrinolytic agent) and thrombin that is
reconstituted with calcium chloride or distilled
water [203]. Its use in hernia surgery was rst
described by Chevrel etal. in 1997 [204].
For assessment of mesh xation strength,
brin sealant was found to be comparable with
mechanical xation techniques (level of evidence, 5) [205]. In vitro biomechanical models,
open and laparo-endoscopic, have suggested that
the combination of brin sealants with sutures
generates a signicantly higher mesh xation
strength, with bursting pressure of 196mmHg,
when compared to the use of sutures alone (bursting pressure 188mmHg) [157, 206]. This is not
true for brin sealant alone, with animal models
of open and laparo-endoscopic repair nding no
difference between brin sealant and other
mechanical xation techniques including sutures,
staples and tacks [184, 207–210]. Level 1B evidence suggests that recurrence rates with brin
sealant xation are comparable with mechanical
xation devices in laparo-endoscopic TAPP
[211] and TEP [212] and open inguinal hernia
repair [206, 213–216]. Expectedly, brin sealant
has higher xation strength at 12days postoperatively when compared to non-xation technique
[207, 217].
Level 5 evidence suggested that thrombin concentration of 4IU/ml is preferable to 500IU/ml
and has higher xation strength [218].
In the assessment of postoperative incidence
of chronic pain in open and laparo-endoscopic
(TEP and TAPP) inguinal hernia repair, level 1B
evidence shows that brin sealant results in lower
postoperative chronic pain rates up to 1 year
compared to mechanical xation including staples, tacks and sutures [169, 174, 202, 206, 211,
212, 216, 219]. The TIMELI trial compared
brin sealant to suture xation in a randomized
control trial of 319 patients undergoing open
inguinal hernia repair (Lichtenstein method). At
1year postoperatively, they found a signicantly
lower rate of patients with one or more disabling
complication (chronic pain, numbness or groin
discomfort) in the brin sealant group compared
to the suture group (8.1% vs. 14.8%, p=0.0344),
with a lower analgesic requirement (65.2% vs.
79.7%, p = 0.0009) [220]. Conversely a case
series reported no difference between brin sealant xation and staples in terms of chronic postoperative pain following TAPP repair of inguinal
hernia [213].
The ability of patients to return early to work
following TAPP repair of inguinal hernia was
found to be faster amongst those who underwent
brin sealant mesh xation compared to the staple or anchor mesh xation (5days vs. 7–9days)
[216] or suture xation [169]. Conversely, in TEP
repair of inguinal hernia, there was no difference
in return to daily activity or length of hospital
stay between the brin sealant and staple xation
[212].
There is insufcient and conicting evidence
in the literature with regard to the postoperative
wound complications, namely, seroma formation
and wound infection. Some studies reported
deceased incidence of seroma formation following open incisional hernia and TAPP repair of
inguinal hernia with brin sealant xation compared to mechanical xation methods [214, 221].
However, these ndings were conicting with
other studies which revealed no difference in
seroma formation between these xation methods [204]. In terms of wound infection, it was
found that the use of brin sealant might result in
reduction in the rate of postoperative infection
[204, 222]; however, opposing studies concluded
that there was no change in the rate of
postoperative infection regardless of the xation
techniques [174, 219, 223]. There is a lack of
consistent evidence with regard to operative time,
reduced hospital stay and cost effectiveness with
brin sealant xation compared to other xation
methods [211–213, 224].
6.3.2.4 Staple Fixation
Titanium surgical staples are uncommonly used
for mesh xation in laparo-endoscopic surgery as
well as open hernia repair [181, 213, 225–236].
One of the criticisms of the use of staplers in
hernia surgery is the cost compared to sutures
[237]. The literature search has revealed conicting evidence in this subject.
For assessment of the strength of mesh xation in inguinal hernia repair, level 5 evidence
6 Materials, Devices andGadgets forHernia Surgery
67
suggested that mesh xation strength with staples is higher than no xation of mesh [207, 223]
and is comparable to sutures [170] and brin
sealant [184].
In regard to the incidence of hernia recurrence
following open and laparo-endoscopic (TEP and
TAPP) inguinal hernia repair, level 1B evidence
has suggested that staple xation has comparable
recurrence rates compared with other xation
techniques including sutures and brin sealant
[180, 181, 187, 211–214, 219, 238–241].
The incidence of postoperative chronic pain
was comparable following open inguinal hernia
repair using staple xation compared to suture
xation (level 2B) [180, 181, 213] and with no
xation [238–241]. However in comparison with
brin sealant, surgical staples mesh xation was
found to result in higher rates of chronic postoperative pain following open and TEP repair of
inguinal hernia (level of evidence, 1B) [206, 211,
212, 219].
Level 1B evidence suggested that there is no
difference in postoperative infection rates with
staple xation compared to sutures or brin sealant in open or laparo-endoscopic (TEP and
TAPP) inguinal hernia repair [180, 181, 187, 213,
219].
Regarding seroma formation, there is a conicting evidence in the literature with lower
seroma rates in the staple xation compared to
brin sealant in TEP repair of inguinal hernia
repairs [212], however with higher incidence in
TAPP [214].
6.3.2.5 Tacks andAnchor Fixation
Tacks are spiral-shaped pins that are made of
either a non-absorbable titanium or an absorbable
material such as polyester (e.g. AbsorbaTack™
Covidien™). The tacks are shaped like a ship’s
anchor with two forks rather than a spiral shape.
They are made of nitinol, which is a composite of
nickel and titanium. The use of surgical tacks has
been widely adopted in laparo-endoscopic inguinal and incisional hernia repair where suturing is
often technically challenging and time consuming. They can either be positioned in a single row
of tacks around the outer border of the mesh,
sometimes combined with sutures, or more com-
monly in ‘double crown’ fashion as an inner and
outer row.
Literature has revealed that the tack xation
technique has comparable results to other xation methods in terms of xation strength and the
recurrence rates in TAPP and TEP repair of
inguinal hernia as well as laparo-endoscopic
repair of incisional hernias [154, 156, 193, 195,
216, 242–247]. In laparo-endoscopic incisional
hernia repair, there is some concern regarding
adhesions, especially with intraperitoneal placement of mesh and the tacks as it comes in contact
with the viscera. There is no difference in the literature in terms of adhesion formation between
non-absorbable and absorbable tacks (level of
evidence, 5) [156]. Similarly, there is no clear
difference in adhesion formation between tacks,
sutures, staples and brin sealant [177, 179].
In terms of postoperative pain, there is conicting evidence in the literature between tack
xation and no mesh xation in TEP repair of
inguinal hernia [164, 246–248]. Compared with
brin sealant xation, tack xation was found to
result in higher pain rates in TAPP inguinal hernia
repair [216]. Similarly higher pain rates were
found when compared with sutures in laparoendoscopic incisional hernia repair [195, 196].
Level 2B of evidence has found no difference
in wound infection rates with tack xation compared to brin sealant or anchors in laparo-endoscopic (TAPP) inguinal hernia repair [216].
Similarly, there is no difference in wound infection rates when compared to no xation of mesh
in TEP inguinal hernia repair (level of evidence,
3) [249]. There is insufcient evidence with
regard to handling of tacks compared to other
xation device, and in laparo-endoscopic incisional hernia repair, there is no difference in
operative time with tack xation compared to
transabdominal sutures [246, 249] (level of evidence, 2B).
6.3.2.6 No Fixation
The idea of hernia repairs without mesh xation
approach has emerged to overcome possible
complications associated with mechanical xation methods. This method takes advantage of
mesh rigidity when placed in a closed anatomical
68
D. L. Sanders et al.
space that will eventually be secured by mesh
ingrowth, especially the case in TEP inguinal
hernia repair and open sublay incisional hernia
repair. The recommendation from the
International Endohernia Society, along with the
published European guidelines in July 2011 on
TEP and TAPP inguinal hernia repair, was that all
but the largest hernia defects (risk of mesh dislocation or folding leading to inadequate overlap
with tissues and hernia recurrence) could be
repaired without mesh xation [250].
Level 1A evidence has suggested that in terms
of recurrence rates, there is no difference when
comparing no xation to mechanical xation in
laparo-endoscopic (TEP) inguinal hernia repair
[246, 247, 251, 252]. Similar results were found
in a meta-analysis of eight RCTs, showing no
signicant difference in recurrence, chronic pain
or length of stay for all laparoscopic inguinal hernia repairs [253]. It is not unexpected that nonxation of the mesh approach in TEP inguinal
hernia repair was found to signicantly reduce
the operative time and the cost (level 1A evidence) [251, 252].
6.3.2.7 Self-Fixing Mesh
The self-xing meshes are characterized by a
stronger xation compared to the no-xation
approach and with reduced prosthetic load compared to the mechanical xation methods.
There are currently two self-xing meshes on
the commercial market. Adhesix® (Cousin
Biotech) is a lightweight polypropylene mesh that
has one-side coated with a hydrogel synthetic
glue. ProGrip™ (Covidien™) is a lightweight
polyester mesh that has polylactic acid absorbable
hooks on one side of the mesh, acting like ‘Velcro’
to hold the mesh in place.
Evidence (level 4) has suggested that self-xing meshes have a recurrence rate comparable
with suture xation in open inguinal hernia repair
[254–256]. In an inguinal hernia animal model, it
was reported that the ingrowth was better with a
self-xing mesh (Adhesix®) compared with
suture xation [171]. There is limited evidence
on their efcacy in laparo-endoscopic repairs;
however, two case series demonstrate promising
results [257, 258].
Lower rates of chronic postoperative pain
were noted following open inguinal hernia repair
using ProGrip™ self-xing mesh [259] or
Adhesix® mesh [256] compared to suture xation. The operative time in open inguinal hernia
repair was reported to be shorter with self-xing
meshes compared to suture xation (23 mins
(15–32) vs. 31min (21–40) P=0.01) [171, 259].
In summary a moderate quality systematic
review of 12 RCTs found no signicant difference
in recurrence rates or infections rates between all
xation methods, and although chronic pain rates
were found to be different (sutures 14.7%, glue
7.6%, brin sealant 3.7%, self-xing 18.2%), this
was non-signicant in 9 out of 12 RCTs [260].
Conclusion
There are several hundred different products
on the market that can be used in the repair of
different types of hernias; however, the ‘ideal’
prosthetic product has yet to be found. We are,
as yet, unable to predict the most suitable type
of mesh for each hernia and patient type. In
addition, it should be remembered that the
type of mesh and the xation technique are
only two factors amongst a list of important
variables that inuence the outcomes in hernia
surgery.
References
1. Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J,
Andersen FH, Wara P, etal. Quality assessment of
26,304 herniorrhaphies in Denmark: a prospective
nationwide study. Lancet. 2001;358(9288):1124–8.
2. Rutkow IM. Demographic and socioeconomic
aspects of hernia repair in the United States in 2003.
Surg Clin North Am. 2003;83(5):1045–51. v-vi.
3. Bisgaard T, Bay-Nielsen M, Kehlet H.Re-recurrence
after operation for recurrent inguinal hernia. A
nationwide 8-year follow-up study on the role of
type of repair. Ann Surg. 2008;247(4):707–11.
4. Bay-Nielsen M, Kehlet H, Strand L, Malmstrom
J, Andersen FH, Wara P, et al. The Danish Hernia
Database—four years’ results. Ugeskr Laeger.
2004;166(20):1894–8.
5. Burger JW, Luijendijk RW, Hop WC, Halm JA,
Verdaasdonk EG, Jeekel J.Long-term follow up of a
randomized control trial of suture versus mesh repair
of incisional hernia. Ann Surg. 2004;240(4):578–85.
6 Materials, Devices andGadgets forHernia Surgery
69
6. Shankaran V, Weber DJ, Reed RL II, Luchette FA.A
review of available prosthetics for ventral hernia
repair. Ann Surg. 2011;253(1):16–26.
7. Goepel R. Uber die Verschliessung von
Bruchpforten durch Einheilung geochtener fertiger
Silberdrahtnetze. Zentralbl Chir. 1900;17:3.
8. Perry. Implantations of Silver Filigree for cure of
large ventral hernia; report of two cases. Boston Med
Surg J. 1904;151:2.
9. Witzel O.Uber den Verschluss van Bauchwunden
und Bruchpforten durch versenkte Silberdrahtnetze.
Zetralbl Chir. 1900;27:3.
10. Phelps A.A new operation for hernia. N Y Med J.
1894;60.
11. Douglas DM.Repair of large herniae with tantalum
gauze an experimental and clinical study. Lancet.
1948;1(6512):936–9.
12. Throckmorton TD.Tantalum gauze in the repair of
hernias complicated by tissue deciency; a preliminary report. Surgery. 1948;23(1):32–46.
13. Koontz AR, Kimberly RC. Tantalum and marlex
mesh (with a note on marlex thread):an experimental
and clinical comparison—preliminary report. Ann
Surg. 1960;151:796–804.
14. Preston DJ, Richards CF.Use of wire mesh prostheses in the treatment of hernia. 24 years’ experience.
Surg Clin North Am. 1973;53(3):549–54.
15. Mathieson AJ, James JH.A review of inguinal hernia repair using stainless steel mesh. J R Coll Surg
Edinb. 1975;20(1):58–62.
16. Thomeret G, Dubost C, Pillot P. The use of
inoxydizable steel gauze in the treatment of
eventrations of hernias. Mem Acad Chir (Paris).
1960;86:500–7.
17. Cumberland VH.A preliminary report on the use of
prefabricated nylon weave in the repair of ventral
hernia. Med J Aust. 1952;1(5):143–4.
18. Doran FS, Gibbins RE, Whitehead R.A report on
313 inguinal herniae repaired with nylon nets. Br J
Surg. 1961;48:430–4.
19. Usher FC, Wallace SA.Tissue reaction to plastics; a
comparison of nylon, orlon, dacron, teon, and marlex. AMA Arch Surg. 1958;76(6):997–9.
20. DeBord JR. The historical development of prosthetics in hernia surgery. Surg Clin North Am.
1998;78(6):973–1006. vi.
21. Usher FC, Ochsner J, Tuttle LL Jr. Use of marlex
mesh in the repair of incisional hernias. Am Surg.
1958;24(12):969–74.
22. Adloff M, Amaud JP.Surgical management of large
incisional hernias by an intraperitoneal Mersilene
mesh and an aponeurotic graft. Surg Gynecol Obstet.
1987;165(3):204–6.
23. Asarias JR, Nguyen PT, Mings JR, Gehrich AP,
Pierce LM. Inuence of mesh materials on the
expression of mediators involved in wound healing.
J Invest Surg. 2011;24(2):87–98.
24. Majercik S, Tsikitis V, Iannitti DA.Strength of tissue
attachment to mesh after ventral hernia repair with
synthetic composite mesh in a porcine model. Surg
Endosc. 2006;20(11):1671–4.
25. Woloson G.Biochemistry, immunology, and tissue
response to prosthetic material. In: Bendavid R, editor. Abdominal wall hernias: principles and management. 1. Berlin: Springer; 2001. p.201–20.
26. Wagh PV, Leverich AP, Sun CN, White HJ, Read
RC.Direct inguinal herniation in men: a disease of
collagen. J Surg Res. 1974;17(6):425–33.
27. Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj
RS, Klosterhalfen B. Abnormal collagen I to III
distribution in the skin of patients with incisional
hernia. Eur Surg Res. 2000;32(1):43–8.
28. Si Z, Bhardwaj R, Rosch R, Mertens PR,
Klosterhalfen B, Klinge U.Impaired balance of type
I and type III procollagen mRNA in cultured broblasts of patients with incisional hernia. Surgery.
2002;131(3):324–31.
29. Bellon JM, Bujan J, Honduvilla NG, Jurado F,
Gimeno MJ, Turnay J, et al. Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes. Eur J Clin
Invest. 1997;27(6):510–6.
30. Bellon JM, Bajo A, Ga-Honduvilla N, Gimeno MJ,
Pascual G, Guerrero A, etal. Fibroblasts from the
transversalis fascia of young patients with direct
inguinal hernias show constitutive MMP-2 overexpression. Ann Surg. 2001;233(2):287–91.
31. Offner E. Pathophysiology and pathology of the
foreign-body reaction. In: Schumpelick LN, editor. Meshes: benets and risks. 1. Berlin: Springer;
2004. p.161–9.
32. Kaufmann SH. Immunity to intracellular bacteria.
Annu Rev Immunol. 1993;11:129–63.
33. Klinge U, Klosterhalfen B, Birkenhauer V, Junge K,
Conze J, Schumpelick V. Impact of polymer pore
size on the interface scar formation in a rat model. J
Surg Res. 2002;103(2):208–14.
34. Laschke MW, Haufel JM, Thorlacius H, Menger
MD.New experimental approach to study host tissue response to surgical mesh materials invivo. J
Biomed Mater Res A. 2005;74(4):696–704.
35. Bellon JM, Bujan J, Contreras L, Hernando
A.Integration of biomaterials implanted into abdominal wall: process of scar formation and macrophage
response. Biomaterials. 1995;16(5):381–7.
36. Tang L, Lucas AH, Eaton JW. Inammatory
responses to implanted polymeric biomaterials: role
of surface-adsorbed immunoglobulin G.J Lab Clin
Med. 1993;122(3):292–300.
37. Tang L, Eaton JW.Inammatory responses to biomaterials. Am J Clin Pathol. 1995;103(4):466–71.
38. Tang L, Eaton JW. Fibrin(ogen) mediates acute
inammatory responses to biomaterials. J Exp Med.
1993;178(6):2147–56.
39. Pereira-Lucena CG, Artigiani-Neto R, Lopes-Filho
GJ, Frazao CV, Goldenberg A, Matos D, et al.
Experimental study comparing meshes made of
polypropylene, polypropylene + polyglactin and
polypropylene + titanium: inammatory cytokines,
70
D. L. Sanders et al.
histological changes and morphometric analysis of
collagen. Hernia. 2010;14(3):299–304.
40. Luttikhuizen DT, Harmsen MC, Van Luyn
MJ.Cellular and molecular dynamics in the foreign
body reaction. Tissue Eng. 2006;12(7):1955–70.
41. Vroman L, Adams AL. Identication of absorbed
protein lms by exposure to antisera and water
vapor. J Biomed Mater Res. 1969;3(4):669–71.
42. Hunt JA, Flanagan BF, McLaughlin PJ, Strickland
I, Williams DF.Effect of biomaterial surface charge
on the inammatory response: evaluation of cellular
inltration and TNF alpha production. J Biomed
Mater Res. 1996;31(1):139–44.
43. Iannitti DA, Hope WW, Tsikitis V.Strength of tissue attachment to composite and ePTFE grafts after
ventral hernia repair. JSLS. 2007;11(4):415–21.
44. Welty G, Klinge U, Klosterhalfen B, Kasperk R,
Schumpelick V. Functional impairment and complaints following incisional hernia repair with
different polypropylene meshes. Hernia. 2001;
5(3):142–7.
45. Bellon JM, Rodriguez M, Garcia-Honduvilla N,
Gomez-Gil V, Pascual G, Bujan J. Postimplant
behavior of lightweight polypropylene meshes in an
experimental model of abdominal hernia. J Invest
Surg. 2008;21(5):280–7.
46. Novitsky YW, Harrell AG, Cristiano JA, Paton BL,
Norton HJ, Peindl RD, etal. Comparative evaluation
of adhesion formation, strength of ingrowth, and textile properties of prosthetic meshes after long-term
intra-abdominal implantation in a rabbit. J Surg Res.
2007;140(1):6–11.
47. Harrell AG, Novitsky YW, Cristiano JA, Gersin KS,
Norton HJ, Kercher KW, et al. Prospective histologic evaluation of intra-abdominal prosthetics four
months after implantation in a rabbit model. Surg
Endosc. 2007;21(7):1170–4.
48. Vrijland WW, Bonthuis F, Steyerberg EW, Marquet
RL, Jeekel J, Bonjer HJ. Peritoneal adhesions to
prosthetic materials: choice of mesh for incisional
hernia repair. Surg Endosc. 2000;14(10):960–3.
49. Conze J, Rosch R, Klinge U, Weiss C, Anurov M,
Titkowa S, etal. Polypropylene in the intra-abdominal position: inuence of pore size and surface area.
Hernia. 2004;8(4):365–72.
50. Klinge U, Klosterhalfen B, Muller M, Ottinger AP,
Schumpelick V. Shrinking of polypropylene mesh
invivo: an experimental study in dogs. Eur J Surg.
1998;164(12):965–9.
51. Gonzalez R, Fugate K, McClusky D III, Ritter EM,
Lederman A, Dillehay D, etal. Relationship between
tissue ingrowth and mesh contraction. World J Surg.
2005;29(8):1038–43.
52. Bellon JM, Garcia-Honduvilla N, Rodriguez M,
Pascual G, Gomez-Gil V, Bujan J.Inuence of the
structure of new generation prostheses on shrinkage
after implant in the abdominal wall. J Biomed Mater
Res B Appl Biomater. 2006;78((2):340–6.
53. Klinge U, Klink CD, Klosterhalfen B.The “ideal”
mesh—more than a mosquito net. Zentralbl Chir.
2010;135(2):168–74.
54. Bringman S, Conze J, Cuccurullo D, Deprest J,
Junge K, Klosterhalfen B, etal. Hernia repair: the
search for ideal meshes. Hernia. 2010;14(1):81–7.
55. Hamer-Hodges DW, Scott NB.Surgeon’s workshop.
Replacement of an abdominal wall defect using
expanded PTFE sheet (Gore-tex). J R Coll Surg
Edinb. 1985;30(1):65–7.
56. Schumpelick V, Klinge U. Prosthetic implants for
hernia repair. Br J Surg. 2003;90(12):1457–8.
57. Doctor HG.Evaluation of various prosthetic materials and newer meshes for hernia repairs. J Minim
Access Surg. 2006;2(3):110–6.
58. Sanders DL, Kingsnorth AN. Prosthetic mesh
materials used in hernia surgery. Expert Rev Med
Devices. 2012;9(2):159–79.
59. Bendavid R.Abdominal wall hernias: principles and
management. NewYork: Springer; 2001. xxxiv, 792
p., [16] p. of plates p.
60. Usher FC.Hernia repair with Marlex mesh. An analysis of 541 cases. Arch Surg. 1962;84:325–8.
61. Zieren J, Maecker F, Neuss H, Muller JM.Trevira
mesh: a promising new implant for the treatment
of abdominal hernias. Langenbecks Arch Surg.
2002;387(1):8–13.
62. Wantz GE. Incisional hernioplasty with Mersilene.
Surg Gynecol Obstet. 1991;172(2):129–37.
63. Riepe G, Loos J, Imig H, Schroder A, Schneider
E, Petermann J, etal. Long-term invivo alterations
of polyester vascular grafts in humans. Eur J Vasc
Endovasc Surg. 1997;13(6):540–8.
64. Morris-Stiff GJ, Hughes LE.The outcomes of nonabsorbable mesh placed within the abdominal cavity: literature review and clinical experience. J Am
Coll Surg. 1998;186(3):352–67.
65. Harrison JH. A teon weave for replacing tissue
defects. Surg Gynecol Obstet. 1957;104(5):584–90.
66. Gibson LD, Stafford CE.Synthetic mesh repair of
abdominal wall defects: follow up and reappraisal.
Am Surg. 1964;30:481–6.
67. Elliott MP, Juler GL. Comparison of Marlex mesh
and microporous teon sheets when used for hernia repair in the experimental animal. Am J Surg.
1979;137(3):342–4.
68. Murphy JL, Freeman JB, Dionne PG.Comparison
of Marlex and Gore-tex to repair abdominal wall
defects in the rat. Can J Surg. 1989;32(4):244–7.
69. Sher W, Pollack D, Paulides CA, Matsumoto
T.Repair of abdominal wall defects: Gore-Tex vs.
Marlex graft. Am Surg. 1980;46(11):618–23.
70. Lamb JP, Vitale T, Kaminski DL.Comparative evaluation of synthetic meshes used for abdominal wall
replacement. Surgery. 1983;93(5):643–8.
71. Pans A, Pierard GE. A comparison of intraperitoneal prostheses for the repair of abdominal muscular wall defects in rats. Eur Surg Res. 1992;
24(1):54–60.
72. Simmermacher RK, van der Lei B, Schakenraad JM,
Bleichrodt RP.Improved tissue ingrowth and anchorage of expanded polytetrauoroethylene by perforation: an experimental study in the rat. Biomaterials.
1991;12(1):22–4.