Abstract
Polypropylene (PP) surgical mesh, used successfully for the surgical repair of abdominal hernias, is associated with serious clinical complications when used in the pelvic floor for repair of stress urinary incontinence or support of pelvic organ prolapse. While manufacturers claim that the material is inert and non-degradable, there is a growing body of evidence that asserts PP fibres are subject to oxidative damage and indeed explanted material from patients suffering with clinical complications has shown some evidence of fibre cracking and oxidation. It has been proposed that a pathological cellular response to the surgical mesh contributes to the medical complications; however, the mechanisms that trigger the specific host response against the material are not well understood. Specifically, this study was constructed to investigate the mechano–chemical effects of oxidation and dynamic distension on polypropylene surgical mesh. To do this we used a novel advanced spectroscopical characterisation technique, secondary electron hyperspectral imaging (SEHI), which is based on the collection of secondary electron emission spectra in a scanning electron microscope (SEM) to reveal mechanical–chemical reactions within PP meshes.
Highlights
Implantable mesh made of polypropylene (PP) bres has been used surgically to treat so tissue repair since the 1950s
A er dynamic distension in dH2O for 6 h, both Gynemesh and Restorelle exhibited a steeper gradient in the average stress– strain curves than that of the control non-stretched material
This study introduced a simple novel in vitro test method which has the potential of evaluating future PP mesh materials for clinical suitability without the requirement for initial in vivo studies
Summary
Implantable mesh made of polypropylene (PP) bres has been used surgically to treat so tissue repair since the 1950s This surgical mesh designed with a knitted pattern has been used to treat complex hernias and other abdominal wall procedures. In the 1970s, the same mesh was introduced for pelvic oor repair.[1] Several corporations around the globe designed and manufactured a wide range of different mesh products for these medical applications representing a huge market in the medical device eld.[1] the mesh was not tested for the site of implantation on the assumption that a mesh that worked well in the abdomen would work well in the pelvic oor. This assumption has proved to be incorrect and patients have suffered from sustained in ammation around the mesh, with pain, mesh
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