Prosthetic Materials for Hernia Repair: Polypropylene
In the United States, general surgeons perform about 900,000 hernia repairs every year. There has been an explosion of new synthetic materials available to aid in closing these anatomic defects. These polymers fall into the following three categories – polypropylene, polyester, and polytetraflouroethylene (PTFE).
Polypropylene prosthetics are widely used. They can vary siginificantly in porosity, weave, and density. Products with lower density and larger pore size may cause less inflammatory response and less contracture because of the relatively thinner scar formed, with a comcomitant improvement in outcomes. However, this lesser inflammatory response must be balanced against rates of recurrence.
Some commonly used brands of polypropylene mesh for inguinal hernia repair are listed below:
Bard 3D Max – manufactured by Davol, Inc., relatively heavyweight material.
PerFix Plug – manufactured by Davol, Inc., prone to contracture and migration as a relatively large amount of scar tissue decreases its size.
Kugel Patch – manufactured by Davol, Inc, has a flat surface with an attached ring.
Prolene Hernia System – manufactured by Ethicon, heavyweight mesh that has an on-lay sheet with an attached plug that is placed in the preperitoneal position to reduce plug migration. Used only in open hernia repair.
Prolite Mesh and Plug – manufactured by Atrium Medical Corporation, this is relatively porous, lightweight material.
Proloop Mesh Plug – manufactured by Atrium Medical Corporation, relatively porous, lightweight material.
Surgipro – manufactured by US Surgical, comes in open-weave, and mono- and multi-filament.
Some commonly used brands of polypropylene mesh for ventral hernia repair are listed below:
Supramesh-IP – manufactured by Genzyme, composite material of polypropylene and polyglycolic acid woven together, also coated on one side with a gel mixture of sodium hyaluronate, carboxymethylcellulose, and polyethylene glycol.
Proceed – manufactured by Ethicon, coated with a proprietary cellulose based polymer.
C-Qur – manufactured by Atrium Medical, absorbs in 10-12 weeks, coated with processed fish oil on both sides