Relationship between tissue ingrowth and mesh contraction

Rodrigo Gonzalez, Kim Fugate, David McClusky, E. Matt Ritter, Andrew Lederman, Dirk Dillehay, C. Daniel Smith, Bruce Ramshaw

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Contraction is a well-documented phenomenon occurring within two months of mesh implantation. Its etiology is unknown, but it is suggested to occur as a result of inadequate tissue ingrowth into the mesh and has been associated with hernia recurrence. In continuation of our previous studies, we compared tissue ingrowth characteristics of large patches of polyester (PE) and heavyweight polypropylene (PP) and their effect on mesh contraction. The materials used were eight PE and eight PP meshes measuring 10 × 10 cm2. After random assignment to the implantation sites, the meshes were fixed to the abdominal wall fascia of swine using interrupted polypropylene sutures. A necropsy was performed three months after surgery for evaluation of mesh contraction/shrinkage. Using a tensiometer, tissue ingrowth was assessed by measuring the force necessary to detach the mesh from the fascia. Histologic analysis included inflammatory and fibroblastic reactions, scored on a 0-4 point scale. One swine developed a severe wound infection that involved two PP meshes and was therefore excluded from the study. The mean area covered by the PE meshes (87 ± 7 cm2) was significantly larger than the area covered by the PP meshes (67 ± 14 cm2) (p = 0.006). Tissue ingrowth force of the PE meshes (194 ± 37 N) had a trend toward being higher than that of the PP meshes (159 ± 43 N), although it did not reach statistical significance. There was no difference in histologic inflammatory and fibroblastic reactions between mesh types. There was a significant correlation between tissue ingrowth force and mesh size (p = 0.03, 95% CI: 0.05-0.84). Our results confirm those from previous studies in that mesh materials undergo significant contraction after suture fixation to the fascia. PE resulted in less contraction than polypropylene. A strong integration of the mesh into the tissue helps prevent this phenomenon, which is evidenced by a significant correlation between tissue ingrowth force and mesh size.

Original languageEnglish (US)
Pages (from-to)1038-1043
Number of pages6
JournalWorld Journal of Surgery
Volume29
Issue number8
DOIs
StatePublished - Aug 1 2005

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Polypropylenes
Polyesters
Fascia
Sutures
Swine
Abdominal Wall
Wound Infection
Hernia
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Gonzalez, R., Fugate, K., McClusky, D., Ritter, E. M., Lederman, A., Dillehay, D., ... Ramshaw, B. (2005). Relationship between tissue ingrowth and mesh contraction. World Journal of Surgery, 29(8), 1038-1043. https://doi.org/10.1007/s00268-005-7786-0

Relationship between tissue ingrowth and mesh contraction. / Gonzalez, Rodrigo; Fugate, Kim; McClusky, David; Ritter, E. Matt; Lederman, Andrew; Dillehay, Dirk; Smith, C. Daniel; Ramshaw, Bruce.

In: World Journal of Surgery, Vol. 29, No. 8, 01.08.2005, p. 1038-1043.

Research output: Contribution to journalArticle

Gonzalez, R, Fugate, K, McClusky, D, Ritter, EM, Lederman, A, Dillehay, D, Smith, CD & Ramshaw, B 2005, 'Relationship between tissue ingrowth and mesh contraction', World Journal of Surgery, vol. 29, no. 8, pp. 1038-1043. https://doi.org/10.1007/s00268-005-7786-0
Gonzalez R, Fugate K, McClusky D, Ritter EM, Lederman A, Dillehay D et al. Relationship between tissue ingrowth and mesh contraction. World Journal of Surgery. 2005 Aug 1;29(8):1038-1043. https://doi.org/10.1007/s00268-005-7786-0
Gonzalez, Rodrigo ; Fugate, Kim ; McClusky, David ; Ritter, E. Matt ; Lederman, Andrew ; Dillehay, Dirk ; Smith, C. Daniel ; Ramshaw, Bruce. / Relationship between tissue ingrowth and mesh contraction. In: World Journal of Surgery. 2005 ; Vol. 29, No. 8. pp. 1038-1043.
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