Porosity and tissue integration of elastic mesh implants evaluated in vitro and in vivo. Ciritsis, A., Horbach, A., Staat, M., Kuhl, C., K., & Kraemer, N., A. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 106(2):827-833, 2, 2018.
Porosity and tissue integration of elastic mesh implants evaluated in vitro and in vivo [link]Website  abstract   bibtex   
© 2017 Wiley Periodicals, Inc. Purpose: In vivo, a loss of mesh porosity triggers scar tissue formation and restricts functionality. The purpose of this study was to evaluate the properties and configuration changes as mesh deformation and mesh shrinkage of a soft mesh implant compared with a conventional stiff mesh implant in vitro and in a porcine model. Material and Methods: Tensile tests and digital image correlation were used to determine the textile porosity for both mesh types in vitro. A group of three pigs each were treated with magnetic resonance imaging (MRI) visible conventional stiff polyvinylidene fluoride meshes (PVDF) or with soft thermoplastic polyurethane meshes (TPU) (FEG Textiltechnik mbH, Aachen, Germany), respectively. MRI was performed with a pneumoperitoneum at a pressure of 0 and 15 mmHg, which resulted in bulging of the abdomen. The mesh-induced signal voids were semiautomatically segmented and the mesh areas were determined. With the deformations assessed in both mesh types at both pressure conditions, the porosity change of the meshes after 8 weeks of ingrowth was calculated as an indicator of preserved elastic properties. The explanted specimens were examined histologically for the maturity of the scar (collagen I/III ratio). Results: In TPU, the in vitro porosity increased constantly, in PVDF, a loss of porosity was observed under mild stresses. In vivo, the mean mesh areas of TPU were 206.8 cm 2 (± 5.7 cm 2 ) at 0 mmHg pneumoperitoneum and 274.6 cm 2 (± 5.2 cm 2 ) at 15 mmHg; for PVDF the mean areas were 205.5 cm 2 (± 8.8 cm 2 ) and 221.5 cm 2 (± 11.8 cm 2 ), respectively. The pneumoperitoneum-induced pressure increase resulted in a calculated porosity increase of 8.4% for TPU and of 1.2% for PVDF. The mean collagen I/III ratio was 8.7 (± 0.5) for TPU and 4.7 (± 0.7) for PVDF. Conclusion: The elastic properties of TPU mesh implants result in improved tissue integration compared to conventional PVDF meshes, and they adapt more efficiently to the abdominal wall.
@article{
 title = {Porosity and tissue integration of elastic mesh implants evaluated in vitro and in vivo},
 type = {article},
 year = {2018},
 identifiers = {[object Object]},
 keywords = {Digital image correlation (DIC),Elastic mesh implant,Porosity,Tensile tests,Thermoplastic polyurethane (TPU),Tissue integration},
 pages = {827-833},
 volume = {106},
 websites = {http://doi.wiley.com/10.1002/jbm.b.33877},
 month = {2},
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 abstract = {© 2017 Wiley Periodicals, Inc. Purpose: In vivo, a loss of mesh porosity triggers scar tissue formation and restricts functionality. The purpose of this study was to evaluate the properties and configuration changes as mesh deformation and mesh shrinkage of a soft mesh implant compared with a conventional stiff mesh implant in vitro and in a porcine model. Material and Methods: Tensile tests and digital image correlation were used to determine the textile porosity for both mesh types in vitro. A group of three pigs each were treated with magnetic resonance imaging (MRI) visible conventional stiff polyvinylidene fluoride meshes (PVDF) or with soft thermoplastic polyurethane meshes (TPU) (FEG Textiltechnik mbH, Aachen, Germany), respectively. MRI was performed with a pneumoperitoneum at a pressure of 0 and 15 mmHg, which resulted in bulging of the abdomen. The mesh-induced signal voids were semiautomatically segmented and the mesh areas were determined. With the deformations assessed in both mesh types at both pressure conditions, the porosity change of the meshes after 8 weeks of ingrowth was calculated as an indicator of preserved elastic properties. The explanted specimens were examined histologically for the maturity of the scar (collagen I/III ratio). Results: In TPU, the in vitro porosity increased constantly, in PVDF, a loss of porosity was observed under mild stresses. In vivo, the mean mesh areas of TPU were 206.8 cm 2 (± 5.7 cm 2 ) at 0 mmHg pneumoperitoneum and 274.6 cm 2 (± 5.2 cm 2 ) at 15 mmHg; for PVDF the mean areas were 205.5 cm 2 (± 8.8 cm 2 ) and 221.5 cm 2 (± 11.8 cm 2 ), respectively. The pneumoperitoneum-induced pressure increase resulted in a calculated porosity increase of 8.4% for TPU and of 1.2% for PVDF. The mean collagen I/III ratio was 8.7 (± 0.5) for TPU and 4.7 (± 0.7) for PVDF. Conclusion: The elastic properties of TPU mesh implants result in improved tissue integration compared to conventional PVDF meshes, and they adapt more efficiently to the abdominal wall.},
 bibtype = {article},
 author = {Ciritsis, Alexander and Horbach, Andreas and Staat, Manfred and Kuhl, Christiane K. and Kraemer, Nils Andreas},
 journal = {Journal of Biomedical Materials Research Part B: Applied Biomaterials},
 number = {2}
}

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