How to Construct a Mesh? Impact of Structure, Filament and Pore Size for Tissue Ingrowth

Abstract

With a great and steadily growing variety of meshes offered in the worldwide market, surgeons more and more face the difficulty in making a choice for their ideal prosthesis in hernia repair. Especially with regard to long intervals of implan- tation, the comprehension of the in vivo situation of mesh implants is of major importance. As in recent decades intensive research in the field of wound-healing properties, tissue response and mesh integration has been performed, an update is overdue. Furthermore, the answer to the question on how to construct a mesh should provide the arguments for which mesh should be used. In general, various aspects have to be respected in the evaluation of the quality and functionality of a mesh construction. First of all, it is important to note that the incorporation of biomaterials causes an inflammatory reaction that more or less persists during the lifetime of the implant [1]. In this respect, the biocompa- tibility of alloplastic prostheses is defined by the tissue response to the foreign body which is dependent on different characteristics: the amount of material (size and surface), the polymer type, the structure and the kind of filament (mono- ver- sus multifilament). Furthermore, determining mechanical characteristics of the mesh materials are their tensile strength and elasticity, as well as the predisposi- tion to infections. Naturally, in the development of surgical meshes, all these para- meters afford particular consideration. Amount