Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8109, St. Louis, MO 63110, USA.
Surg Endosc. 2011 May;25(5):1541-52. doi: 10.1007/s00464-010-1432-0. Epub 2010 Oct 26.
This study aimed to compare the physicomechanical properties of composite prostheses for laparoscopic ventral hernia repair (LVHR) through standard testing and a proposed classification system.
Seven prostheses (four with absorbable barriers and 3 with nonabsorbable barriers) were evaluated. The barrier layer was removed, after which the area of the interstices and the diameter of the filaments were determined. The barrier layer was left intact during thickness, density, suture retention strength, tear resistance, uniaxial tensile, and ball-burst testing. Specimens were oriented parallel or perpendicular to their longest dimension during testing. One-way analysis of variance (ANOVA) with Tukey's posttest or an unpaired, two-tailed t-test was performed to determine whether differences existed due to mesh or orientation, and a p value<0.05 was considered significant.
Significant differences were observed between mesh types and due to the orientation of the mesh during testing. Of the absorbable barrier meshes, Bard Sepramesh IP Composite demonstrated the greatest suture retention and tear strengths, followed by C-QUR mesh. Of the permanent barrier meshes, DUALMESH demonstrated the greatest suture retention strength in the perpendicular direction, followed by Bard Composix E/X. DUALMESH and Bard Composix E/X demonstrated equivalent suture retention strength in the parallel direction and equivalent tear resistance in both testing directions. All meshes demonstrated tensile strengths greater than the physiologically relevant range of 16-32 N/cm.
This study provided a basic understanding of how the structural aspects of each mesh design influence functionality. Differences between composite barrier prostheses commonly used for LVHR were observed due to barrier type, mesh type, and orientation. A set of standard testing techniques and a classification system also were presented to define fully the properties of these materials.
本研究旨在通过标准测试和提出的分类系统比较腹腔镜腹疝修补术（LVHR）用复合补片的物理机械性能。
对 7 种补片（4 种带可吸收屏障，3 种带不可吸收屏障）进行评估。去除屏障层后，确定网孔的面积和纤维丝的直径。在厚度、密度、缝线保持力、抗撕裂、单轴拉伸和球爆破试验中，保持屏障层完整。在测试中，标本沿其最长尺寸平行或垂直取向。采用单因素方差分析（ANOVA）和 Tukey 检验或非配对双尾 t 检验，以确定是否因网孔或取向的不同而存在差异，p 值<0.05 认为有统计学意义。
在网孔类型和测试中网孔的取向方面均观察到显著差异。在可吸收屏障网孔中，Bard Sepramesh IP Composite 的缝线保持力和抗撕裂强度最大，其次是 C-QUR 网孔。在永久性屏障网孔中，DUALMESH 在垂直方向的缝线保持力最大，其次是 Bard Composix E/X。DUALMESH 和 Bard Composix E/X 在平行方向的缝线保持力相等，在两个测试方向的抗撕裂强度相等。所有网孔的拉伸强度均大于生理相关的 16-32 N/cm。
本研究提供了对每种网孔设计的结构方面如何影响功能的基本了解。由于屏障类型、网孔类型和取向的不同，LVHR 常用的复合屏障补片之间存在差异。还提出了一套标准测试技术和分类系统，以充分定义这些材料的性能。
