Mosquito Net Mesh for Abdominal Wall Hernioplasty: A Comparison of Material Characteristics with Commercial Prosthetics
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Mosquito Net Mesh for Abdominal Wall Hernioplasty: A Comparison of Material Characteristics with Commercial Prosthetics David L. Sanders • Andrew N. Kingsnorth Brian M. Stephenson
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Published online: 24 January 2013 Ó Socie´te´ Internationale de Chirurgie 2013
Abstract Background The use of sterilized mosquito net as a cheaper alternative to commercial mesh used in hernia repair has previously been published. However, as no standards with regard to the material have been documented, we aimed to define the characteristics of a commonly available and low-cost mosquito net, which has already been shown to be clinically efficacious in groin hernia repair. We compared its characteristics to other commercially available meshes, in keeping with the wellestablished FDA and MHRA regulatory processes. Methods The macromolecular structure of the mosquito net was determined by vibrational spectroscopy. The ultrastructure of the meshes was examined with scanning electron microscopy, and uniaxial and burst tensile strength testing was performed. The following parameters were assessed: polymer type, filament characteristics, pore size, weight, linear density, elasticity, and tensile strength. Results The mosquito net was a polyethylene homopolymer, knitted from monofilament fibers with a mean filament diameter of 109.7 lm and a mean mesh thickness of 480 lm. The mean pore maximum diameter was 1.9 mm, D. L. Sanders (&) Department of Surgery, Royal Cornwall Hospital, Truro TR1 3LJ, UK e-mail: [email protected] A. N. Kingsnorth ‘‘Operation Hernia’’, Department of Surgery, Derriford Hospital, Plymouth PL6 8DH, UK e-mail: [email protected] B. M. Stephenson Department of Surgery, Royal Gwent Hospital, Newport, South Wales NP20 2UB, UK e-mail: [email protected]
with 91.2 % porosity, 53.7 g/m2 mean mesh weight, and a linear mass density of 152 denier. This was comparable to the ‘‘large pore’’ (class I) commercial meshes. The bursting force for polyethylene mosquito net was greater than for UltraPro and Vypro (43.0 vs. 35.5 and 27.2 N/cm, respectively), and the mosquito net exhibited less anisotropy compared to the commercial meshes. Conclusions The material and mechanical properties of the polyethylene mosquito net are substantially equivalent to those of commonly used lightweight commercial meshes.
Introduction The implications of neglected inguinal hernias in resourcelimited settings are well documented [1–7]. In rural areas of underdeveloped countries, where poverty is endemic and modern healthcare is a luxury, there is an unspoken global acceptance of allowing patients to live with chronic disabilities such as hernias [8]. In these settings, solutions that entertain cheaper alternative and innovative technologies are clearly worth exploring. One example is the use of sterilized mosquito net as an alternative to the more expensive commercial mesh used in hernia repair. The use of prosthetic mesh to reinforce the abdominal wall in inguinal hernia repair is now accepted as the gold standard and has led to re
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