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  4. Dynamic intermittent strain can rapidly impair ventral hernia repair
 
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Dynamic intermittent strain can rapidly impair ventral hernia repair

Publikationstyp
Journal Article
Date Issued
2015-11-26
Sprache
English
Author(s)
Kallinowski, Friedrich  
Baumann, Elena  
Harder, Felix  
Siassi, Michael  
Mahn, Axel  
Vollmer, Matthias  
Morlock, Michael  
Institut
Biomechanik M-3  
TORE-URI
http://hdl.handle.net/11420/2964
Journal
Journal of biomechanics  
Volume
48
Issue
15
Start Page
4026
End Page
4036
Citation
Journal of Biomechanics 15 (48): 4026-4036 (2015-11-26)
Publisher DOI
10.1016/j.jbiomech.2015.09.045
Scopus ID
2-s2.0-84952862749
Ventral hernia repair fails frequently despite advanced mesh inserting surgery. A model for dynamic intermittent straining (DIS) of ventral hernia repairs was developed. The influence of phospholipids, position, overlap, fixation and tissue quality of various meshes on the durability of hernia repair was studied.DIS comprises the repetition of submaximal impacts delivered via a hydraulically driven plastic containment. Pig tissues simulate a ventral hernia with a standardized 5. cm defect. Commercially available meshes strengthened with tacks, glue and sutures were used to bridge this defect in an underlay (IPOM) or sublay (retromuscular) position starting with a 5. cm overlap in all directions. We tested 35 different ways of ventral hernia repair with up to 425 submaximal intermittent dynamic impacts until mesh dislocation occurred 10 times or a maximum of 4000 impacts each were withstood.The likelihood of a failing repair was related to the mesh, the lubricants, the position, the overlap, the fixation and the tissue quality. Most meshes dislocated easily and required fixation. One of the meshes tested was stable without fixation with a 5. cm overlap and failed after reducing the overlap. Phospholipids exerted a strong influence on the biomaterial tested. The sublay position was about 10% more durable in comparison to the IPOM position. DIS revealed distinct degrees of stability with primarily stable, intermediate and primarily unstable repairs.Based on the DIS results available, the currently used ventral hernia repair options can be classified. In the future, DIS investigations can improve the durability of hernia repair.
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