Introducing the Mesh Integration (MINT) Index: a standardised ratio scale for assessing in vivo hernia mesh...

Area of Science:

• Biomedical Engineering
• Surgical Innovation
• Materials Science

Background:

• Incisional hernias affect 1 in 15 individuals, with poor mesh integration causing long-term repair failure.
• Standardized assessment of in vivo hernia mesh behavior is crucial for improving surgical outcomes.
• Existing methods lack objectivity and reproducibility in evaluating mesh performance.

Purpose of the Study:

• To develop a standardized, objective index for assessing hernia mesh integration and behavior within the abdominal wall.
• To create a reproducible tool applicable across different research settings and compatible with existing methodologies.
• To provide a quantitative measure for evaluating mesh performance in vivo.

Main Methods:

• Defined core properties for the index: objectivity, reproducibility, independence from animal models, and compatibility with existing research.
• Built the index structure based on a pilot study and literature review, incorporating key measurements and testing methods.
• Utilized high-precision testing methods aligned with international standards where applicable.

Main Results:

• Introduced the Mesh Integration (MINT) Index, a 0-5 ratio scale for quantifying in vivo mesh behavior.
• The index encompasses integration, fibrosis, adhesion, and degradation, using visual, histological, biomechanical, and molecular assessments.
• Score calculations and rationale were detailed, excluding biomarkers due to interpretation uncertainties.

Conclusions:

• An objective index for assessing in vivo hernia mesh behavior has been successfully created.
• The MINT Index requires further validation through studies involving explanted mesh tissue from living abdominal walls.
• This tool promises to standardize the evaluation of hernia mesh performance, potentially improving patient outcomes.