Skip to main content
SpringerLink
Log in

Shrinkage and biomechanical evaluation of lightweight synthetics in a rabbit model for primary fascial repair

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The experiment evaluated different lightweights (<32 g/m2) in terms of shrinkage and biomechanics.

Methods

PP-8 (polypropylene of 7.6 g/m2), PP-s (PP-8 with absorbable sheets), PP-32 (PP with absorbable fibers; 32.0 g/m2) and polyvinylidinefluoride (PVDF; 24.9 g/m2) augmented primary sutured repairs of the anterior abdominal wall in a total of 40 rabbits. Rabbits were implanted by only one type of mesh at four abdominal sites. After 7, 14, 30, 60 and 120 days, 2 rabbits were sacrificed per group. Three additional unoperated rabbits were used as controls. Shrinkage and uni-axial tensiometry were evaluated.

Results

PP-s implants wrinkled in 70%. PP-32 did not shrink whereas PP-8 and PVDF shrank by 20%. Explants were as strong as the controls; however, they differed in compliance. At lower stress, the tested materials were equally stiff.

Conclusions

The biomechanical behaviour of the tested lightweights does not mimic that of native controls. Weight reduction does not prevent shrinkage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Jia X, Glazener C, Mowatt G, MacLennan G, Bain C, Fraser C et al (2008) Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta-analysis. BJOG 115:1350–1361

    Article  PubMed  CAS  Google Scholar 

  2. Quiroz LH, Gutman RE, Shippey S, Cundiff GW, Sanses T, Blomquist JL et al (2008) Abdominal sacrocolpopexy: anatomic outcomes and complications with Pelvicol, autologous and synthetic graft materials. Am J Obstet Gynecol 198:557 e1–5

    Article  Google Scholar 

  3. Altman D, Anzen B, Brismar S, Lopez A, Zetterstrom J (2006) Long-term outcome of abdominal sacrocolpopexy using xenograft compared with synthetic mesh. Urology 67:719–724

    Article  PubMed  Google Scholar 

  4. Deprest J, De Ridder D, Roovers J, Werbrouck E, Coremans G, Claerhout F (2009) Medium term outcome of laparoscopic sacrocolpopexy with xenografts as compared to synthetic grafts. Urology 182(5):2362–2368

    Article  Google Scholar 

  5. Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S (2008) Surgical management of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn 27:3–12

    Article  PubMed  CAS  Google Scholar 

  6. Feiner B, Jelovsek JE, Maher C (2009) Efficacy and safety of transvaginal mesh kits in the treatment of prolapse of the vaginal apex: a systematic review. BJOG 116:15–24

    PubMed  CAS  Google Scholar 

  7. Bako A, Dhar R (2009) Review of synthetic mesh-related complications in pelvic floor reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct 20:103–111

    Article  PubMed  Google Scholar 

  8. Kohli N, Walsh PM, Roat TW, Karram MM (1998) Mesh erosion after abdominal sacrocolpopexy. Obstet Gynecol 92:999–1004

    Article  PubMed  CAS  Google Scholar 

  9. Cobb WS, Kercher KW, Heniford BT (2005) The argument for lightweight polypropylene mesh in hernia repair. Surg Innov 12:63–69

    Article  PubMed  Google Scholar 

  10. Klinge U, Klosterhalfen B, Birkenhauer V, Junge K, Conze J, Schumpelick V (2002) Impact of polymer pore size on the interface scar formation in a rat model. J Surg Res 103:208–214

    Article  PubMed  CAS  Google Scholar 

  11. Jones KA, Feola A, Meyn L, Abramowitch SD, Moalli PA (2009) Tensile properties of commonly used prolapse meshes. Int Urogynecol J 20(7):847–853

    Article  Google Scholar 

  12. Ozog Y, Konstantinovic ML, Verschueren S, Spelzini F, De Ridder D, Deprest J (2009) Experimental comparison of abdominal wall repair using different methods of enhancement by small intestinal submucosa graft. Int Urogynecol J Pelvic Floor Dysfunct 20(4):435–441

    Article  PubMed  Google Scholar 

  13. Sergent F, Desilles N, Lacoume Y, Bunel C, Marie JP, Marpeau L (2009) Experimental biomechanical evaluation of polypropylene prostheses used in pelvic organ prolapse surgery. Int Urogynecol J Pelvic Floor Dysfunct. Epub ahead of print

  14. Movat HZ (1955) Demonstration of all connective tissue elements in a single section; pentachrome stains. AMA Arch Pathol 60:289–295

    PubMed  CAS  Google Scholar 

  15. Rubod C, Boukerrou M, Brieu M, Jean-Charles C, Dubois P, Cosson M (2008) Biomechanical properties of vaginal tissue: preliminary results. Int Urogynecol J Pelvic Floor Dysfunct 19(6):811–816

    Article  PubMed  Google Scholar 

  16. Junge K, Rosch R, Krones CJ, Klinge U, Mertens PR, Lynen P et al (2005) Influence of polyglecaprone 25 (Monocryl) supplementation on the biocompatibility of a polypropylene mesh for hernia repair. Hernia 9:212–217

    Article  PubMed  CAS  Google Scholar 

  17. Conze J, Junge K, Weiss C, Anurov M, Oettinger A, Klinge U et al (2008) New polymer for intra-abdominal meshes—PVDF copolymer. J Biomed Mater Res B Appl Biomater 87:321–328

    PubMed  Google Scholar 

  18. Konstantinovic ML, Pille E, Malinowska M, Verbeken E, De Ridder D, Deprest J (2007) Tensile strength and host response towards different polypropylene implant materials used for augmentation of fascial repair in a rat model. Int Urogynecol J Pelvic Floor Dysfunct 18(6):619–626

    Article  PubMed  Google Scholar 

  19. Konstantinovic ML, Ozog Y, Spelzini F, Pottier C, De Ridder D, Deprest J (2009) Biomechanical findings in rats undergoing fascial reconstruction with graft materials suggested as an alternative to polypropylene. Neurourol Urodyn 29(3):488–493

    Google Scholar 

  20. Garcia-Urena MA, Vega Ruiz V, Diaz Godoy A, Baez Perea JM, Marin Gomez LM, Carnero Hernandez FJ et al (2007) Differences in polypropylene shrinkage depending on mesh position in an experimental study. Am J Surg 193:538–542

    Article  PubMed  CAS  Google Scholar 

  21. Klinge U, Klosterhalfen B, Muller M, Ottinger AP, Schumpelick V (1998) Shrinking of polypropylene mesh in vivo: an experimental study in dogs. Eur J Surg 164:965–969

    Article  PubMed  CAS  Google Scholar 

  22. Klosterhalfen B, Junge K, Klinge U (2005) The lightweight and large porous mesh concept for hernia repair. Expert Rev Med Devices 2:103–117

    Article  PubMed  Google Scholar 

  23. Deprest J, Zheng F, Konstantinovic M, Spelzini F, Claerhout F, Steensma A et al (2006) The biology behind fascial defects and the use of implants in pelvic organ prolapse repair. Int Urogynecol J Pelvic Floor Dysfunct 17(Suppl 1):S16–S25

    PubMed  Google Scholar 

  24. Bellon JM, Garcia-Honduvilla N, Rodriguez M, Pascual G, Gomez-Gil V, Bujan J (2006) Influence of the structure of new generation prostheses on shrinkage after implant in the abdominal wall. J Biomed Mater Res B Appl Biomater 78:340–346

    PubMed  CAS  Google Scholar 

  25. Epstein LB, Graham CA, Heit MH (2007) Systemic and vaginal biomechanical properties of women with normal vaginal support and pelvic organ prolapse. Am J Obstet Gynecol 197:165 e1–6

    Article  Google Scholar 

  26. Epstein LB, Graham CA, Heit MH (2008) Impact of sacral colpopexy on in vivo vaginal biomechanical properties. Am J Obstet Gynecol 199:664 e1–6

    Article  Google Scholar 

  27. Epstein LB, Graham CA, Heit MH (2008) Correlation between vaginal stiffness index and pelvic floor disorder quality-of-life scales. Int Urogynecol J Pelvic Floor Dysfunct 19:1013–1018

    Article  PubMed  Google Scholar 

  28. Abramowitch SD, Feola A, Jallah Z, Moalli PA (2009) Tissue mechanics, animal models, and pelvic organ prolapse: a review. Eur J Obstet Gynecol Reprod Biol 144(Suppl 1):S146–S158

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

This work was supported by an unconditional grant from Johnson & Johnson Medical (Norderstedt Germany). The company did not interfere with the planning, execution or reporting of this experiment and is neither the owner of the results. The authors have no financial interests in this company.

Author information

Authors and Affiliations

  1. Center for Surgical Technologies, Faculty of Medicine, Universitair Ziekenhuis “Gasthuisberg” Leuven, Katholieke Universiteit Leuven, Minderbroedersstraat 19, Box 1034, 3000, Leuven, Belgium

    Yves Ozog, Maja L. Konstantinovic, Erika Werbrouck & Jan Deprest

  2. Pelvic Floor Unit, Universitair Ziekenhuis “Gasthuisberg” Leuven, Katholieke Universiteit Leuven, Leuven, Belgium

    Maja L. Konstantinovic, Erika Werbrouck, Dirk De Ridder & Jan Deprest

  3. Department of Mechanical and Process Engineering, Swiss Federal Institute of Technology, Zurich, Switzerland

    Mazza Edoardo

  4. EMPA Materials Science and Technology, Dübendorf, Zurich, Switzerland

    Mazza Edoardo

Authors
  1. Yves Ozog
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maja L. Konstantinovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erika Werbrouck
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dirk De Ridder
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mazza Edoardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jan Deprest
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jan Deprest.

Additional information

This work was awarded with the Young Investigators Award at the biannual joint meeting of the International Continence Society the International Urogynecology Association, held in Toronto, ON, August 23-27, 2010.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ozog, Y., Konstantinovic, M.L., Werbrouck, E. et al. Shrinkage and biomechanical evaluation of lightweight synthetics in a rabbit model for primary fascial repair. Int Urogynecol J 22, 1099–1108 (2011). https://doi.org/10.1007/s00192-011-1440-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-011-1440-1

Keywords

Search

Navigation