Shrinkage of Dynamesh IPOM mesh in 6-week follow-up - an experimental study

Introduction: The process of shrinkage of a mesh in the peritoneal cavity is not fully understood, but it may cause reduction of the implant area down to 30-50%. Therefore, knowledge on the magnitude of the phenomenon for the used prosthesis enables proper sizing. This reduces the relapse rate on the one hand and the use of excess material, being a “foreign body”, on the other hand. Aim: 1. To assess shrinkage of Dynamesh IPOM (intraperitoneal onlay mesh) implanted into the peritoneal cavity in 6-week follow-up. 2. To assess whether the type of slow-absorbable suture used to attach the prosthesis affects the process. Material and methods: The study was conducted in an animal model (swine). In each one of 12 animals two mesh fragments were implanted. In each case, one fragment was sutured with PDS II and the other one with Maxon. After 6 weeks, mesh area was measured and compared with respective baseline values, calculating linear shortening and area loss. The second part of the analysis was addressed to determine the effect of the used suture on the phenomenon. To do this, mesh linear and area loss was calculated for both groups (PDS and Maxon), and the results were compared with Mann-Whitney U test. Results and conclusion: 1. Dynamesh IPOM demonstrates linear shortening by 12.53% and area loss of 23.85% after 6 weeks. These values are significant and should be accounted for during implant sizing. 2. There was no statistically significant difference in shrinkage parameters in the groups with meshes attached with PDS II and Maxon.