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Suture Techniques and Selection
Published in Chih-Chang Chu, J. Anthony von Fraunhofer, Howard P. Greisler, Wound Closure Biomaterials and Devices, 2018
S.S. Kang, W. Irvin, J.R. Perez-Sanz, H. P. Greisler
For secure placement of surgical mesh, sutures should be placed approximately ¼ in. from the edge of the mesh, and should be spaced ¼ to ½ in. apart. Nonabsorbable suture, preferably of the same material as the mesh, should be used to secure the nonabsorbable mesh. When the meshes are used in infants and children likely to experience further growth, the surgeon should be aware that these materials are limiting and will not expand to accommodate future growth potential.
Global sensitivity analysis of membrane model of abdominal wall with surgical mesh
Published in Wojciech Pietraszkiewicz, Wojciech Witkowski, Shell Structures: Theory and Applications Volume 4, 2017
K. Szepietowska, I. Lubowiecka, B. Magnain, E. Florentin
Ventral hernia occurs commonly as a postoperative complication after abdominal surgeries (Gillion et al. 2016). It can be treated by implantation of a surgical mesh. The study addresses the issues of laparoscopic ventral hernia repair. Recurrences or an excessive mesh bulging still happen, the consensus on the best properties of implant is still searched.
The effect of fabric structure on the bursting characteristics of warp-knitted surgical mesh
Published in The Journal of The Textile Institute, 2020
Melika Badin Dahesh, Azita Asayesh, Ali Asghar Asgharian Jeddi
In medicine, protrusion of whole or part of a viscera from its original location in the body through a hole in its retaining wall is called hernia (Pollard, 2011). The hernia may occur in both women and men and has a variety of types like abdominal hernia, inguinal hernia, incisional hernia, umbilical hernia, femoral hernia, etc., the most prevalent type is the abdominal hernia and inguinal hernia. Hernia treatment involves closing the defect area using suture or surgical mesh (Pollard, 2011). Hernia therapy methods are classified into three general categories, including herniorrhaphy, open mesh hernioplasty, and laparoscopic mesh repair (Alam Shah, 2012). Surgical mesh is a porous fabric that is chiefly produced by warp-knitting method using polypropylene, polyester, or polytetrafluoroethylene monofilament. The most significant factors in choosing a surgical mesh are the raw materials and the structural and mechanical parameters of the mesh that should be compatible with the physiological conditions of the body (Zhu, Schuster & Klinge, 2015). Surgical meshes are categorized into lightweight, mid-weight, and heavyweight based on their weight (Bilsel & Abci, 2012). The heavyweight meshes are stronger than the lightweight meshes, but they also increase the side effects such as adhesion formation, pain, and body reaction to the foreign body. Moreover, they disrupt the normal movements of the abdominal wall due to their higher stiffness and tendency to shrink compared to lightweight meshes (Bringman et al., 2010). Based on pore size, surgical meshes are classified as macroporous and microporous. Microporous meshes are more prone to the formation of a scar around the mesh due to the lack of soft tissue ingrowth, which leads to the reduction of mesh compliance. Moreover, microporous meshes undergo higher infection than macroporous mesh. Instead, macroporous meshes are more compatible with the body (Burns-Heffner, 2014). Different tests are utilized to investigate the mechanical properties of surgical meshes, including tensile strength test, bursting strength test, tear resistance test, and suture retention test (Todros, Pavan, Pachera & Natali, 2017).
The influence of mesh structure and strain level on the stress relaxation of warp-knitted surgical mesh for hernia repair
Published in The Journal of The Textile Institute, 2022
The hernia is a common disease in human societies. The surgical operation using surgical mesh is a reliable and effectual method to repair the hernia. Surgical mesh ensure structural stability and prevent the projection of organs in case of herniation. The success of these synthetic meshes in surgical operation mainly depends on their mechanical performance. Furthermore, the porosity of the mesh is a decisive parameter in the response of living tissue. Surgical meshes are classified as macroporous (pores larger than 75 μm) and microporous (pores smaller than 10 μm). In the meshes with low porosity, the penetration of living tissues into the mesh is less, which leads to scar formation around the mesh. Moreover, the amount of infections that have been reported in case of low-porosity meshes is higher than high-porosity meshes (Todros et al., 2017). Most of the literature in the field of surgical meshes have concerned their structural properties and elastic characteristics using tensile tests (Afonso et al., 2008; Chu & Welch, 1985; Deeken et al., 2011; Edwards et al., 2013; Feola et al., 2013; Gaoming et al., 2005; Junge et al., 2001; Kirilova et al., 2012; Klosterhalfen et al., 2005; Li et al., 2014; Mirjavan et al., 2017; Pott et al., 2012; Saberski et al., 2011; Shepherd et al., 2012 ; Yu et al., 2019). Generally, the ultimate tensile load and deformability of the meshes have been investigated, and few research about their viscoelastic properties are accessible. In viscoelastic materials, the stress decreases with time under constant strain. This phenomenon is called stress relaxation. In other word, stress relaxation is a time-dependent behavior of viscoelastic materials (Lakes, 2009). Due to the viscoelastic nature of surgical meshes, and since these meshes are as a replacement for the abdominal wall, they are exposed to constant strain in the body and consequently are vulnerable to stress relaxation. Furthermore, in the cases of increased intra-abdominal pressure, the mesh is predisposed to subsequent stress relaxation, which leads to the redistribution of the deformed and stressed state of the mesh-tissue structure. Hence, it is advantageous to know the viscoelastic characteristics of the mesh to prevent the relapse of the disease (Kirilova, 2012).