title: Mechanical failure of a lightweight polypropylene mesh.
abstract: We report the case of a 41-year-old male who underwent repair of a recurrent midline abdominal incisional hernia with components separation. The hernia defect was repaired with a 30 cm × 30 cm underlay biological (Strattice) mesh used to partially bridge a small residual gap between the rectus muscles and reinforced with a 30 cm × 30 cm lightweight polypropylene onlay mesh (BARD™ soft mesh). The patient later developed a large persistent seroma that was excised 18 weeks later. On exploration of the previous hernia repair, it was noted that the onlay polypropylene mesh had fractured leaving a 3 cm by 2 cm defect, but the underlying biological mesh was intact preventing a recurrence of the hernia (see Fig. 1). The fractured mesh was repaired with an additional onlay 10 cm × 10 cm polypropylene mesh, the seroma was de-roofed, and the patient was later discharged. This case highlights the early mechanical failure of a lightweight polypropylene mesh; the precise mechanism of failure in this case is unclear and, however, may be related to high intra-abdominal pressures postoperatively. Fig. 1 Photograph showing onlay polypropylene (BARD™ soft mesh) mesh superficial to a biological (Strattice) sublay mesh bridging the recti (on the left and right wound edges). Arrow indicates the 2 cm by 3 cm fracture.
authors: Upper GI Department, Derriford Hospital, Plymouth, UK, luke.lintin@nhs.net.
authors: L A D
authors: LA
authors: Lintin
authors: A N
authors: AN
authors: Kingsnorth
mesh_terms: D000328:Adult; D046449:Hernia, Abdominal / Q000601:surgery; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011126:Polypropylenes; D011475:Prosthesis Failure / Q000209:etiology*; D012008:Recurrence; D013526:Surgical Mesh / Q000009:adverse effects*
chemical_list: D011126:Polypropylenes