Textile prostheses in abdominal and pelvic surgery

Abstract

Textile prostheses have been used in abdominal surgery since ancient times. Industrial development of the last one hundred years changed it from simple cloth to highly improved materials that are better integrated and provide superior functional outcomes. Understanding of the physicochemical properties of surgical meshes is essential for the rational choice of the optimal device. This needs to be closely adapted to mechanical and biological conditions of the anatomical region that will be placed in. The quality of the materials and the manufacturing technique are also of great importance, influencing both the mechanical parameters and the integration of the prosthetic material. Although a hard-to-reach concept, the ideal mesh should have high porosity, a monofilamentous structure and it should be composed of durable, non-carcinogenic, non-allergenic, and highly biocompatible materials. These qualities will ensure a good integration of the prosthesis and will make it easy to handle intraoperatively, resulting in a satisfactory clinical outcome. Based on the above considerations, this article aims to bring to light useful manufacturing information regarding textile prostheses used in surgical reconstructions, in order to support surgeons in making the correct and rational choice of the prosthetic material, based on its physicochemical properties, thus avoiding postoperative complications. Textile implants apply to various surgical fields such as abdominal or thoracic wall reconstruction, visceral defect repair, pelvic floor stabilization or tissue replacement. Postoperative complications of mesh use include chronic pain, infection, ulceration of the wound, adhesion formation, intestinal obstruction, recurrence of parietal defect, rejection of the prosthesis, and mesh granuloma