title: Elastic mesh with thermoplastic polyurethane filaments preserves effective porosity of textile implants.
abstract: In hernia surgery, meshes with small pores tend to be filled by fibrous tissue, which reduces their stretchability and causes patient complaints. Because of the inelasticity of current meshes, mechanical strain might cause pores to collapse even in large-pore mesh constructions. In this study, a mesh with elastic thermoplastic polyurethane (TPU) filaments was constructed to prevent pore size changes even under mechanical strain, and its biocompatibility in comparison with polyvinylidene fluoride (PVDF) was evaluated. A mesh was constructed using PVDF with elastic TPU filaments and mechanically tested. After midline laparotomy in 20 rabbits, we placed a 15 cm × 3 cm mesh as inlay in the defect. Animals were randomized to either the TPU or PVDF group. After 7 or 21 days, mesh expansion was measured under pneumoperitoneum, and abdominal walls were explanted for immunohistochemical investigations. In vitro, TPU meshes showed a slight reduction in effective porosity from 46% at tension-free conditions to 26% under longitudinal and to 34% under transverse strain. The nonelastic PVDF meshes showed a marked reduction in effective porosity from 70% to 7% and 52%, respectively. The TPU mesh had a breaking elongation of 101% and a tensile strength of 35 N/cm. In vivo, both meshes achieved healing of the incision without hernial defect. The TPU mesh maintained its elasticity under pneumoperitoneum. The amount of CD68-positive, Ki67-positive, and apoptotic cells was significantly lower in the TPU group after 7 and 21 days. The newly developed TPU mesh shows elasticity, structural stability, and preserved effective porosity under mechanical strain. Immunohistochemistry indicates superior biocompatibility of TPU mesh compared with PVDF after 7 and 21 days.
authors: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany.
authors: Andreas
authors: A
authors: Lambertz
authors: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany.|Department of General Surgery, Maastricht University Medical Centre, 6211 LK, Maastricht, The, Netherlands.
authors: Ruben R M
authors: RR
authors: Vogels
authors: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany.
authors: Marcel
authors: M
authors: Binnebösel
authors: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany.
authors: Dominik S
authors: DS
authors: Schöb
authors: Institut Fuer Textiltechnik at RWTH Aachen University, 52074, Aachen, Germany.
authors: Klas
authors: K
authors: Kossel
authors: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany.
authors: Uwe
authors: U
authors: Klinge
authors: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany.
authors: Ulf P
authors: UP
authors: Neumann
authors: Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany.
authors: Christian D
authors: CD
authors: Klink
mesh_terms: D000818:Animals; D004548:Elasticity; D005260:Female; D010969:Plastics; D011140:Polyurethanes / Q000737:chemistry*; D016062:Porosity; D019736:Prostheses and Implants; D011817:Rabbits; D013718:Tensile Strength; D013784:Textiles
chemical_list: D010969:Plastics; D011140:Polyurethanes
keywords: effective porosity; elastic mesh; elastic thermoplastic polyurethane (TPU); immunohistochemistry; polyvinylidene fluoride (PVDF); rabbit model; structural stability; tensile tests