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Related Experiment Videos

Absorbable versus permanent mesh in abdominal operations.

J Tyrell1, H Silberman, P Chandrasoma

  • 1Department of Surgery, University of Southern California, School of Medicine, Los Angeles 90033.

Surgery, Gynecology & Obstetrics
|March 1, 1989
PubMed
Summary
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Permanent prosthetic meshes offer superior tensile strength and hernia prevention compared to absorbable options. Absorbable meshes, while causing fewer adhesions, are unsuitable for repairs requiring long-term support.

Area of Science:

  • Biomaterials Science
  • Surgical Innovation
  • Wound Healing Research

Background:

  • Conflicting results exist regarding the efficacy of prosthetic meshes in surgical repairs.
  • Understanding the long-term performance of different mesh types is crucial for clinical decision-making.

Purpose of the Study:

  • To compare permanent (polypropylene, polytetrafluoroethylene) and absorbable (polyglactin, polyglycolic acid) meshes.
  • To evaluate histologic appearance, adhesion formation, tensile strength, and hernia occurrence in a rabbit abdominal wall defect model.

Main Methods:

  • Four types of prosthetic mesh were implanted in rabbit abdominal wall defects (2x3 cm).
  • Histologic evaluation, adhesion scoring, in vitro tensile strength testing, and hernia assessment were performed at 2, 5, 7, and 10 weeks.

Related Experiment Videos

  • Twenty experiments were conducted for each material.

    • Main Results:

    • Minimal inflammatory response was observed with all mesh types.
    • Polypropylene (Marlex) induced more adhesions than polytetrafluoroethylene (Gore-tex); no difference was noted between absorbable meshes.
    • Polypropylene demonstrated superior tensile strength at 10 weeks; polyglactin (Vicryl) was stronger than polyglycolic acid (Dexon) among absorbable meshes.
    • No hernias occurred with permanent meshes, while all rabbits receiving absorbable meshes developed ventral hernias by week 10.

    Conclusions:

    • Absorbable meshes are not suitable for repairs demanding prolonged tensile strength.
    • Permanent meshes are indicated for abdominal wall defect repairs requiring sustained mechanical support.
    • Absorbable meshes may have utility in temporary fascial defect repair, as evisceration was not observed.