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Shrinking of polypropylene mesh in vivo: an experimental study in dogs
U Klinge1, B Klosterhalfen, M Müller
1Department of Surgery of the RWTH Aachen, Germany.
Objective:
To assess the extent of shrinkage of meshes used for hernia repair.
Design:
Experimental study in dogs.
Setting:
University hospital, Germany and University Research Centre, Moscow.
Animals:
10 dogs had monofilament polypropylene meshes that weighed 95 g/m2 (Marlex) or multifilament reduced polypropylene meshes combined with polyglactin 910 that weighed 55 g/m2 (Soft Hernia Mesh) implanted for either 3 or 6 months.
Main Outcome Measures:
Histological appearance and radiological assessment of the position and area of the mesh.
Results:
After 4 weeks the area of mesh in the monofilament group was reduced from to 139 (11) to 75 (8) cm2 (54%) and that of the multifilament from 116 (18) to 77 (20) cm2 (66%). The multifilament mesh with the reduced amount of polypropylene showed less inflammatory response and less shrinkage. The mesh did not seem to have moved.
Conclusion:
Meshes that contain a lot of polypropylene shrink to about 30%-50% of their original size after 4 weeks, requiring an overlap of at least 3 cm if implanted subfascially. Reduction in the polypropylene content decreases both the inflammatory response and the shrinkage. Meshes with big pores are less likely to fold and improve compatibility.