Persistence of polypropylene mesh anisotropy after implantation: an experimental study

Objective: To determine whether anisotropy persisted after incorporation into the host, using a standardised rabbit model for abdominal wall reconstruction.

Design: Investigator-initiated prospective-controlled experimental study.

Setting: Centre for Surgical Technologies, Medical Faculty KU-Leuven.

Sample: Fifteen New Zealand White rabbits.

Methods: In each rabbit, four full thickness primarily repaired abdominal wall defects were covered by a 4 × 5-cm Prolift+M implant (Johnson & Johnson, Norderstedt, Germany), either with the stiffest (n = 6 rabbits) or most elastic (n = 6) direction parallel to the body axis. Prolift+M contains 32 g/m² polypropylene, reinforced with polyglecaprone fibres. Harvesting was performed after 30, 60 and 120 days (n = 2 each time-point). The abdominal wall of three unoperated rabbits was used as negative control.

Main outcome measures: Contraction, compliance and maximal strain and stress determined by uniaxial tensiometry.

Results: Anisotropy properties persist at lower, more physiological displacements, but not at higher displacements. The stiffness of a mesh-augmented repair in the lower strain range remains above that of native tissue. Eventual mesh contraction was limited to 4.3%.

Conclusions: Anisotropic properties of Prolift+M persist in vivo and shrinkage is minimal. Compliance of mesh-augmented repair remains less than that of native tissue. The functional consequences of this remain to be studied.