Surgical mesh

Surgical mesh (also called hernia mash) is a medical implant made of loosely woven mesh, which is used in surgery as either a permanent or temporary structural support for organs and other tissues. Surgical mesh can be made from both inorganic and biological materials and is used in a variety of surgeries, although hernia repair is the most common application. It can also be used for reconstructive work, such as in pelvic organ prolapse[1] or to repair physical defects (mainly of body cavity walls) created by extensive resections or traumatic tissue loss.

Permanent meshes remain in the body, whereas temporary ones dissolve over time. One temporary mesh was shown in 2012 to fully dissolve after three years in a scientific trial on sheep.[2] Some types of mesh combine permanent and temporary meshes which includes both resorbable vicryl, made from polyglycolic acid, and prolene, a non-resorbable polypropylene.[3]

Data of mechanical and biological behaviors of mesh in vivo may not always be reflective of conditions within the human body due to testing in non-human organisms.[4] Most published reports experiment on mice, thus creating the likelihood of possible differences when inserted into the human body. Also, most published research reports reference meshes that are currently disallowed from the medical device market due to complications post-surgery.[5] Additionally, the absence of FDA-approved regulatory protocols and universal standard operating procedures leads to a variety of different testing methods from researcher to researcher. Experimentation may find differing outcomes for some meshes.[6]

  1. ^ "Information on Surgical Mesh for Pelvic Organ Prolapse and Stress Urinary Incontinence". Medical Devices Safety Communications. Food and Drug Administration. 20 November 2012. Archived from the original on June 7, 2009. Retrieved 2 March 2013.
  2. ^ Hjort, H.; Mathisen, T.; Alves, A.; Clermont, G.; Boutrand, J.P. (2012). "Three-year results from a preclinical implantation study of a long-term resorbable surgical mesh with time-dependent mechanical characteristics". Hernia. 16 (2): 191–197. doi:10.1007/s10029-011-0885-y. PMC 3895198. PMID 21972049. After 36 months, the test mesh was fully resorbed
  3. ^ "Vipro 2 mesh". Ethicon product guide. Ethicon. Retrieved 2 March 2013.
  4. ^ Kelly, Michelle; Macdougall, Katherine; Olabisi, Oluwafisayo; McGuire, Neil (February 2017). "In vivo response to polypropylene following implantation in animal models: a review of biocompatibility". International Urogynecology Journal. 28 (2): 171–180. doi:10.1007/s00192-016-3029-1. ISSN 1433-3023. PMC 5306078. PMID 27216918.
  5. ^ Seifalian, Amelia; Digesu, Alex; Khullar, Vikram (April 2024). "The use of animal models in preclinical investigations for the development of a surgical mesh for pelvic organ prolapse". International Urogynecology Journal. 35 (4): 741–758. doi:10.1007/s00192-024-05741-3. ISSN 1433-3023. PMC 11052796. PMID 38358519.
  6. ^ Whitehead-Clarke, T.; Karanjia, R.; Banks, J.; Beynon, V.; Parker, S.; Sanders, D.; Mudera, V.; Windsor, A.; Kureshi, A. (February 2022). "The experimental methodology and comparators used for in vivo hernia mesh testing: a 10-year scoping review". Hernia: The Journal of Hernias and Abdominal Wall Surgery. 26 (1): 297–307. doi:10.1007/s10029-020-02360-x. ISSN 1248-9204. PMC 8881265. PMID 33433739.
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