[Minimized polypropylene mesh for preperitoneal net plasty (PNP) of incisional hernias]

Abstract

Repair of incisional hernias requires the extensive implantation of alloplastic materials. The extent of the scar tissue is markedly regulated by the amount and structure of the incorporated material and is responsible for the increased rate of local wound complications. Correspondingly, minimization of the alloplastic implants should be favorable. In a randomized, prospective clinical study, the early results were compared after implantation of either a minimized, low-weight (26.8 g/m2) mesh with a pore size of 5 mm or a common, heavy-weight (90.2 g/m2 polypropylene) mesh with a pore size of 0.8 mm. Indicators for clinical suitability were the rate and volume of seroma, subjective paraesthesia, physical capability, abdominal wall compliance, and the histologically analyzed tissue reaction of samples removed on the occasion of revision operations. As result, the optimized, low-weight mesh showed a remarkable decrease in the rate of seroma, patient complaints, less restriction of abdominal wall mobility, and improved abdominal wall compliance as verified by 3D stereography. These clinical findings corresponded to a pronounced decrease in inflammation and scar reaction, indicating improved incorporation of the alloplastic material. No other major complications except for one recurrence have been found.