Seguimiento de la contracción de las mallas de polipropileno empleadas en la reparación de eventraciones / Surveillance of shrinkage of polypropylene mesh used in the repair of ventral hernias

Introducción. El polipropileno (PP) es uno de los biomateriales más empleados en la reparación quirúrgica de las eventraciones. Aunque se conoce bien su capacidad de integración tisular en el huésped, se discute si las mallas sufren un proceso de contracción que reduce su tamaño durante el mecanismo de incorporación al proceso de cicatrización del huésped. Objetivo. Cuantificar el proceso de contracción de las mallas de polipropileno. Pacientes y método. Se ha diseñado un estudio de seguimiento radiológico en 23 pacientes consecutivos operados de eventraciones de la línea media con un diámetro mínimo de 5 cm. Las mallas de polipropileno fueron marcadas con clips de titanio en sus ejes mayores transversal y longitudinal. Se realizaron radiografías seriadas el primer día del postoperatorio, al mes, y a los 3, 6 y 12 meses. Se midieron las distancias entre los clips y se calculó el área de la malla. Resultados. Se operó a 17 mujeres y 6 varones. En 9 pacientes la malla se colocó en el espacio supraponeurótico y en 14 en el espacio subaponeurótico. Se produjeron 4 seromas en los pacientes tratados con malla en situación supraponeurótica. La reducción del área calculada ha sido del 12% al mes, 24% a los 3 meses, 29% a los 6 meses y 34% a los 12 meses. Conclusiones. Las mallas de PP han ofrecido excelentes resultados clínicos. En el seguimiento radiológico se ha comprobado una contracción considerable de la malla, fundamentalmente, durante los primeros 3 meses tras el implante (AU)

Introduction. Polypropylene (PP) mesh is one of the most frequently used materials in the surgical repair of ventral hernias. Despite the widely recognized ability of PP to integrate into the host tissue, these meshes may shrink during the healing process in the patient. Objective. To quantify polypropylene mesh shrinkage. Patients and method. A radiological follow-up study was performed in 23 consecutive patients who underwent surgery for midline ventral hernias with diameters of at least 5 cm. PP meshes were marked with titanium clips at the ends of their longest transverse and longitudinal axes. X-rays were performed on the first postoperative day and at 1, 3, 6 and 12 months. The distances between clips were measured and the area of the mesh was calculated. Results. Seventeen women and six men underwent surgery. In nine patients the mesh was placed on the prefascial space (onlay) and in 14 in the subfascial space (sublay). There were four seromas in patients with mesh placed with the onlay technique. The reduction in the calculated area was 12% at 1 month, 24% at 3 months, 29% at 6 months and 34% at 12 months. Conclusions. PP mesh provided excellent clinical results. Radiological surveillance revealed substantial shrinkage, mainly in the first 3 months after implantation (AU)

[Surveillance of shrinkage of polypropylene mesh used in the repair of ventral hernias]. / Seguimiento de la contracción de las mallas de polipropileno empleadas en la reparación de eventraciones.

INTRODUCTION: Polypropylene (PP) mesh is one of the most frequently used materials in the surgical repair of ventral hernias. Despite the widely recognized ability of PP to integrate into the host tissue, these meshes may shrink during the healing process in the patient. OBJECTIVE: To quantify polypropylene mesh shrinkage. PATIENTS AND METHOD: A radiological follow-up study was performed in 23 consecutive patients who underwent surgery for midline ventral hernias with diameters of at least 5 cm. PP meshes were marked with titanium clips at the ends of their longest transverse and longitudinal axes. X-rays were performed on the first postoperative day and at 1, 3, 6 and 12 months. The distances between clips were measured and the area of the mesh was calculated. RESULTS: Seventeen women and six men underwent surgery. In nine patients the mesh was placed on the prefascial space (onlay) and in 14 in the subfascial space (sublay). There were four seromas in patients with mesh placed with the onlay technique. The reduction in the calculated area was 12% at 1 month, 24% at 3 months, 29% at 6 months and 34% at 12 months. CONCLUSIONS: PP mesh provided excellent clinical results. Radiological surveillance revealed substantial shrinkage, mainly in the first 3 months after implantation.