Please use this identifier to cite or link to this item: https://doi.org/10.15480/882.3933
DC FieldValueLanguage
dc.contributor.authorKallinowski, Friedrich-
dc.contributor.authorLudwig, Yannique-
dc.contributor.authorGutjahr, Dominik-
dc.contributor.authorGerhard, Christian-
dc.contributor.authorSchulte-Hörmann, Hannah-
dc.contributor.authorKrimmel, Lena-
dc.contributor.authorLesch, Carolin-
dc.contributor.authorUhr, Katharina-
dc.contributor.authorLösel, Philipp-
dc.contributor.authorVoß, Samuel-
dc.contributor.authorHeuveline, Vincent-
dc.contributor.authorVollmer, Matthias-
dc.contributor.authorGörich, Johannes-
dc.contributor.authorNessel, Regine-
dc.date.accessioned2021-11-25T10:26:28Z-
dc.date.available2021-11-25T10:26:28Z-
dc.date.issued2021-10-29-
dc.identifier.citationFrontiers in Surgery 8: 763957 (2021-10-29)de_DE
dc.identifier.issn2296-875Xde_DE
dc.identifier.urihttp://hdl.handle.net/11420/11062-
dc.description.abstractAim: Hernia repair strengthens the abdominal wall with a textile mesh. Recurrence and pain indicate weak bonds between mesh and tissue. It remains a question which biomechanical factors strengthen the mesh-tissue interface, and whether surgeons can enhance the bond between mesh and tissue. Material and Methods: This study assessed the strength of the mesh-tissue interface by dynamic loads. A self-built bench test delivered dynamic impacts. The test simulated coughing. Porcine and bovine tissue were used for the bench test. Tissue quality, mesh adhesiveness, and fixation intensity influenced the retention power. The influences were condensed in a formula to assess the durability of the repair. The formula was applied to clinical work. The relative strength of reconstruction was related to the individual human abdominal wall. From computerized tomography at rest and during Valsalva's Maneuver, the tissue quality of the individual patient was determined before surgery. Results: The results showed that biomechanical parameters observed in porcine, bovine, and human tissue were in the same range. Tissues failed in distinct patterns. Sutures slackened or burst at vulnerable points. Both the load duration and the peak load increased destruction. Stress concentrations elevated failure rates. Regional areas of force contortions increased stress concentrations. Hernia repair improved strain levels. Measures for improvement included the closure of the defect, use of higher dynamic intermittent strain (DIS) class meshes, increased mesh overlap, and additional fixation. Surgeons chose the safety margin of the reconstruction as desired. Conclusion: The tissue quality has now been introduced into the concept of a critical and a gained resistance toward pressure-related impacts. A durable hernia repair could be designed from available coefficients. Using biomechanical principles, surgeons could minimize pain levels. Mesh-related complications such as hernia recurrence can potentially be avoided in incisional hernia repair.en
dc.language.isoende_DE
dc.publisherFrontiers Mediade_DE
dc.relation.ispartofFrontiers in Surgeryde_DE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/de_DE
dc.subjectbench testde_DE
dc.subjectcomputerized tomographyde_DE
dc.subjectCRIPde_DE
dc.subjectGRIPde_DE
dc.subjecthernia repairde_DE
dc.subjectincisional herniade_DE
dc.subject.ddc600: Technikde_DE
dc.subject.ddc610: Medizinde_DE
dc.titleBiomechanical Influences on mesh-related complications in incisional hernia repairde_DE
dc.typeArticlede_DE
dc.identifier.doi10.15480/882.3933-
dc.type.diniarticle-
dcterms.DCMITypeText-
tuhh.identifier.urnurn:nbn:de:gbv:830-882.0160296-
tuhh.oai.showtruede_DE
tuhh.abstract.englishAim: Hernia repair strengthens the abdominal wall with a textile mesh. Recurrence and pain indicate weak bonds between mesh and tissue. It remains a question which biomechanical factors strengthen the mesh-tissue interface, and whether surgeons can enhance the bond between mesh and tissue. Material and Methods: This study assessed the strength of the mesh-tissue interface by dynamic loads. A self-built bench test delivered dynamic impacts. The test simulated coughing. Porcine and bovine tissue were used for the bench test. Tissue quality, mesh adhesiveness, and fixation intensity influenced the retention power. The influences were condensed in a formula to assess the durability of the repair. The formula was applied to clinical work. The relative strength of reconstruction was related to the individual human abdominal wall. From computerized tomography at rest and during Valsalva's Maneuver, the tissue quality of the individual patient was determined before surgery. Results: The results showed that biomechanical parameters observed in porcine, bovine, and human tissue were in the same range. Tissues failed in distinct patterns. Sutures slackened or burst at vulnerable points. Both the load duration and the peak load increased destruction. Stress concentrations elevated failure rates. Regional areas of force contortions increased stress concentrations. Hernia repair improved strain levels. Measures for improvement included the closure of the defect, use of higher dynamic intermittent strain (DIS) class meshes, increased mesh overlap, and additional fixation. Surgeons chose the safety margin of the reconstruction as desired. Conclusion: The tissue quality has now been introduced into the concept of a critical and a gained resistance toward pressure-related impacts. A durable hernia repair could be designed from available coefficients. Using biomechanical principles, surgeons could minimize pain levels. Mesh-related complications such as hernia recurrence can potentially be avoided in incisional hernia repair.de_DE
tuhh.publisher.doi10.3389/fsurg.2021.763957-
tuhh.publication.instituteBiomechanik M-3de_DE
tuhh.identifier.doi10.15480/882.3933-
tuhh.type.opus(wissenschaftlicher) Artikel-
dc.type.driverarticle-
dc.type.casraiJournal Article-
tuhh.container.volume8de_DE
dc.rights.nationallicensefalsede_DE
dc.identifier.scopus2-s2.0-85119079537de_DE
tuhh.container.articlenumber763957de_DE
local.status.inpressfalsede_DE
local.type.versionpublishedVersionde_DE
local.funding.infoHeidelberger Stiftung Chirurgie Grants Nos. 2016/22, 2017/171, 2018/215, 2019/288, 2020/376, and 2021/444 for the research described in the manuscript, financial support only.de_DE
item.grantfulltextopen-
item.languageiso639-1en-
item.creatorOrcidKallinowski, Friedrich-
item.creatorOrcidLudwig, Yannique-
item.creatorOrcidGutjahr, Dominik-
item.creatorOrcidGerhard, Christian-
item.creatorOrcidSchulte-Hörmann, Hannah-
item.creatorOrcidKrimmel, Lena-
item.creatorOrcidLesch, Carolin-
item.creatorOrcidUhr, Katharina-
item.creatorOrcidLösel, Philipp-
item.creatorOrcidVoß, Samuel-
item.creatorOrcidHeuveline, Vincent-
item.creatorOrcidVollmer, Matthias-
item.creatorOrcidGörich, Johannes-
item.creatorOrcidNessel, Regine-
item.cerifentitytypePublications-
item.openairetypeArticle-
item.creatorGNDKallinowski, Friedrich-
item.creatorGNDLudwig, Yannique-
item.creatorGNDGutjahr, Dominik-
item.creatorGNDGerhard, Christian-
item.creatorGNDSchulte-Hörmann, Hannah-
item.creatorGNDKrimmel, Lena-
item.creatorGNDLesch, Carolin-
item.creatorGNDUhr, Katharina-
item.creatorGNDLösel, Philipp-
item.creatorGNDVoß, Samuel-
item.creatorGNDHeuveline, Vincent-
item.creatorGNDVollmer, Matthias-
item.creatorGNDGörich, Johannes-
item.creatorGNDNessel, Regine-
item.mappedtypeArticle-
item.openairecristypehttp://purl.org/coar/resource_type/c_6501-
item.fulltextWith Fulltext-
crisitem.author.deptBiomechanik M-3-
crisitem.author.orcid0000-0003-4657-9938-
crisitem.author.orcid0000-0003-0506-1171-
crisitem.author.orcid0000-0002-2217-7558-
crisitem.author.parentorgStudiendekanat Maschinenbau-
Appears in Collections:Publications with fulltext
Files in This Item:
File Description SizeFormat
fsurg-08-763957.pdfVerlags-PDF3,88 MBAdobe PDFView/Open
Thumbnail
Show simple item record

Page view(s)

27
checked on Nov 27, 2021

Download(s)

2
checked on Nov 27, 2021

Google ScholarTM

Check

Note about this record

Cite this record

Export

This item is licensed under a Creative Commons License Creative Commons