Impact of a prophylactic mesh on the biomechanics of abdominal wall closure: an animal study

IF 3.3 2区医学 Q2 ENGINEERING, BIOMEDICAL

Journal of the Mechanical Behavior of Biomedical Materials Pub Date : 2025-04-17 DOI:10.1016/j.jmbbm.2025.107014

Anicet Le Ruyet , Baptiste Pillet , Anthony Végleur , Arthur Jourdan , Aline Bel-Brunon , Ludovic Bouré , Baptiste Pierrat

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引用次数: 0

Abstract

Background

The use of a prophylactic prosthetic mesh (PPM) to reinforce a midline laparotomy suture closure improves the clinical outcomes, in comparison with primary suture technique. However, understanding how a PPM impacts the biomechanics of the repair is crucial for gaining a deeper comprehension and ultimately improving clinical outcome by decreasing incisional hernia (IH) rates post midline laparotomy. Based on a porcine IH model, this study aimed to assess the biomechanical characteristics of the abdominal wall (AW) midline over time post midline laparotomy, considering sthree repair modalities: no repair, primary suture and onlay mesh reinforcement coupled with suture.

Methods

31 pigs were enrolled in the study and the repair was characterized using CT-scans based on the distance between the right and left Rectus Abdominis Muscle (RAM). The AW of each animal was explanted at 48 h, 4 and 12 weeks postoperatively and a Stereo Digital Image Correlation (s-DIC)-based method was used to assess the response of the repaired AW (e.g., strain, compliance) when subjected to an inflation test mimicking an increase in intra-abdominal pressure (IAP). Intact AW were included in the study and served as controls.

Results

AWs repaired with a primary suture exhibited a higher RAM distance compared to healthy animals, along with an increased compliance of the repair along the transverse direction over time. AWs repaired with primary suture and reinforced with a PPM exhibited a biomechanical response similar to that of healthy animals in terms of repair strain and compliance.

Conclusion

The use of a PPM to reinforce suture was found to better restore the biomechanical properties to the midline of the AW post midline incision. Further investigations are needed to correlate the findings of this study with clinical outcomes, especially long-term recurrence rates.

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预防性补片对腹壁闭合生物力学的影响：一项动物研究

背景与主要缝合技术相比，使用预防性人工网片（PPM）加固中线开腹手术缝合可改善临床效果。然而，了解 PPM 如何影响修复的生物力学至关重要，只有这样才能更深入地理解，并最终通过降低中线开腹术后切口疝（IH）的发生率来改善临床效果。本研究以猪 IH 模型为基础，旨在评估中线开腹术后随着时间推移腹壁（AW）中线的生物力学特征，同时考虑三种修复方式：无修复、主要缝合和镶嵌网片加固加缝合。在术后 48 小时、4 周和 12 周取出每只动物的腹直肌，并使用基于立体数字图像相关性 (s-DIC) 的方法评估修复后的腹直肌在模拟腹内压 (IAP) 增加的充气试验中的反应（如应变、顺应性）。结果与健康动物相比，用主缝线修复的 AW 显示出更高的 RAM 距离，随着时间的推移，修复处沿横向的顺应性也会增加。用主缝线修复并用 PPM 加固的 AW 在修复应变和顺应性方面表现出与健康动物相似的生物力学反应。本研究的结果与临床结果（尤其是长期复发率）之间的相关性还需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Mechanical Behavior of Biomedical Materials 工程技术-材料科学：生物材料

CiteScore

7.20

自引率

7.70%

发文量

505

审稿时长

46 days

期刊介绍： The Journal of the Mechanical Behavior of Biomedical Materials is concerned with the mechanical deformation, damage and failure under applied forces, of biological material (at the tissue, cellular and molecular levels) and of biomaterials, i.e. those materials which are designed to mimic or replace biological materials. The primary focus of the journal is the synthesis of materials science, biology, and medical and dental science. Reports of fundamental scientific investigations are welcome, as are articles concerned with the practical application of materials in medical devices. Both experimental and theoretical work is of interest; theoretical papers will normally include comparison of predictions with experimental data, though we recognize that this may not always be appropriate. The journal also publishes technical notes concerned with emerging experimental or theoretical techniques, letters to the editor and, by invitation, review articles and papers describing existing techniques for the benefit of an interdisciplinary readership.