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Synthetic Meshes Essay

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1.4.8 Performance of synthetic meshes Synthetic meshes have been widely used through decades as a routine to solve also the most complicated cases, even in cases of clean-contamination with severe comorbidity [202]. The biological response to prosthetic meshes can be characterized by the foreign body reaction, the formation of collagenous tissue, neoperitonealization and neovascularization. Different meshes differ in their host tissue integration. Some studies reported signifficant less strength of host tissue integration for ePTFE or ePTFE-containing meshes than other mesh materials [203-205]. ePTFE (DualMesh®) has been compared with polypropylene (SeprameshTM) in two experimental studies. After 1 month, SeprameshTM showed 30% stronger…show more content…
ParietexTM and ParieteneTM Composite showed to produce fewer adhesions than Sepramesh® [209]. Another study comparing adhesion formation reported Sepramesh® to be superior to ComposixTM [205]. An experimental study compared Prolene®, DualMesh®, Ultrapro®, TiMesh®, SeprameshTM, ParietexTM Composite, Proceed® and Tutomesh® regarding adhesion formation (7 and 30 postoperative days). On postoperative day 30, ParietexTM Composite, Tutomesh® and SeprameshTM reported the smallest amount of adhesions. In a recent study, the adhesion profiles of MarlexTM and Bard® Soft either exposed directly to the viscera or protected with Vicryl® mesh were evaluated. MarlexTM showed smallest adhesion score and the use of Vicryl® as a separating layer did not reduce adhesions [210]. Few human studies concerning intraperitoneal adhesions have been published. Balique et al. [211] evaluated adhesion formation by ultrasound examination. 29 of 80 patients had hernia repair using ParietexTM Composite. After 12 months, 86% of the patients were adhesion free. Another study compared ventral hernia repair with ParietexTM Composite and Mersilene®. 77% of the patients in the Mersilene® group exhibited visceral adhesion to the mesh, while 18% of the patients in the ParietexTM Composite group presented this complication [212]. The occurrence of adhesions in patients who previously had a hernia repair with ePTFE mesh (DualMesh®) was investigated by Koehler et al. [213]. 91% of the patients were described
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