ALTERATION OF ABDOMINAL-WALL MECHANICS AF TER MESH IMPLANATION - EXPERIMENTAL ALTERATION OF MESH STABILITY

The use of biomaterials for incisional hernia markedly reduces the rec urrence rates. Disadvantages are high rates of local wound complicatio ns and restriction of mobility by the rigid ''shell''. The abdominal w all mobility after mesh implantation is analysed for eight different m esh materials. The initial textile testing reveals relevant difference s in structure with marked asymmetry in the different directions. The materials are implanted as inlay in rats for 3, 7, 14, 21 and 90 days. The deformation of the abdominal wall following intraabdominal pressu re of 0-70 mmHg (0-9.81 kPa) is documented by 3D-photogrammetry, the t ensile strength by tearing of excised strips of mesh. Three commercial available materials and two laboratory modifications lead independent ly of their textile characteristics to a marked restriction of the rou nded configuration of the abdominal wall. The tensile strength exceeds by far the physiologically necessary value of 16 N/cm. Three newly de veloped meshes made of multifilament polypropylene with reduced amount s of material (21% and 28% relative to Marlex(R)) lead to no restricti on of the abdominal wall configuration yet have uncompromised stabilit y. It might be possible to reduce the rate of local wound complication s by the use of these newly developed meshes.