The technology is rapidly advancing worldwide, and the field of medicine isn’t exception. Quick relief and faster recovery, along with shorter hospital stays, are among the benefits of modern medicine. One of the most common health issues faced by individuals, especially with increasing age, is the hernia disease. In this article, we will introduce the most important treatment technique for the hernia, namely the use of surgical meshes. We will also explore different types of surgical meshes, such as dual-layer meshes and three-dimensional meshes, and discuss their differences.

What is Hernia and How Does it Occur?

Weakness in the muscles and connective tissues can create a disease called hernia. Hernia is the protrusion of fat, muscle or abdominal organs such as the intestine through the wall of fascia (connective tissue).

The hernia is occur in men and women at all of ages. Some of the main factors to create hernia and intensity’s are include: muscles weakness, heavy loads lifting, intra-abdominal pressure increasing, recurrent constipation, severe coughing, congenital factors, and more.

The Methods for Hernia Repair

When hernia is diagnosed, the patients are monitoring carefully to prevent worsening of the hernia or undergo surgical repair. The hernia surgeries are performed usually by general surgeons or afew cases by urologists.

One of the most procecure in the hernia repair is implanting the surgical mesh on the world. In the hernia repair surgery is use an artificial mesh to cover the site of hernia to prevent its recurrence.

What is Surgical Mesh?

Since hernia develops due to weakness in the abdominal wall, if repair is do solely using  with sutures, this weakness may still persist. Therefore, the surgical mesh is using in the hernia repair surgeries to strengthen the abdominal wall and fascia and also to prevent hernia recurrence.

The surgical mesh is a medical implant to provide more support and to repair the tissue at the hernia site. During hernia surgery, surgical mesh is placing in the damaged area, such as the abdomen or groin, and is secure with sutures.

Over the time, the patient’s tissue is beging to grow typically into the small pores  in  the mesh structure, so is strengthening the muscular wall and preventing the hernia recurrence.

Types of Surgical Mesh

1-Absorbable Mesh

Various types of meshes are used in hernia surgeries. One of the categories is absorbable meshes. The absorbable meshes are degrading over the time and losing their strength. Therefore, they are not suitable for long-term strength maintenance.

These meshes are made from absorbable polymers such as polyglycolic acid or polycaprolactone.

2-Non-absorbable Mesh

The next category is non-absorbable meshes. This type of the meshs does not absorb in the body and is designed for long-term use. The most non-absorbable surgical meshes are made of polypropylene.

The Polypropylene mesh is known  usually prolene mesh. Asia Jarah Pishro, is ready to provide prolene meshs with the best quality to medical centers.

3-Dual Mesh (Bilayer Mesh)

Where the mesh comes into direct contact with internal organs hernia repair surgery is confronting to the dangeros situation. This contact can lead to adhesion of the mesh to organs and subsequent severe complications.

To address this issue, dual meshes were designed. Dual meshes are a category of polymeric meshes and primarily covered with a layer of non-adhesive materials such as silicone or polytetrafluoroethylene (PTFE) and in some cases absorbable fatty acids, cellulose, or collagen. Manufacturers claim these coatings prevent mesh adhesion to surrounding tissues.

Asia Jarah Pishro Company produces dual meshes in the following sizes:

• 30*20 cm
• 15*15 cm
• 15*10 cm (oval)
• 15*10 cm
• 15*7.5 cm
• 11*6 cm

4-Three-dimensional Mesh

Another type of surgical mesh is three-dimensional meshes. The regular meshes woven in 2D,but in the some cases need to  meshes with a 3D structure and they provide support to the tissue in greater volume and thickness.

Where 2D structures cannot completely cover the hernia regions three-dimensional meshes are using to cover hernia formation sites such as the groin..

This mesh repairs reinforcement of the hernia defect in above, below, and center. Three-dimensional meshes are using typically in cosmetic surgeries and for volume augmentation.

Differences between Dual Mesh and Single-layer Mesh

Single-layer meshes have a uniform structure the same on both sides while dual meshes have two unique faces.

One side of dual meshes has a porous and penetrable structure suitable for colonization and fibroblast cell growth and tissue fixation. This side of the mesh is placing on the repaired hernia site to strengthen the facia and the muscular wall.

The other side of smooth dual meshes is usually non-absorbable and non-adhesive, allowing fluid transfer and contact with neighboring organs without adhesion and damage.

According to these descriptions, dual meshes are a very suitable choice for use in surgeries with a high risk of mesh adhesion to internal tissues.

What Features Surgical Mesh needs?

• Chemically neutral
• Chemical stability against body fluids and ions
• Non-inflammatory and non-allergenic
• Mechanical strength sufficient to maintain structure in the body
• Adequate flexibility for easy placement
• Sterilizable
• Suitable pore size

Surgical Mesh with Different Porosity Size

As mentioned earlier, an important aspect of mesh design is the size and shape of its pores. The larger of the pore size and  lighter weigth are important. Thus, a lightweight mesh has large pores, while a heavyweight mesh has small pores. Therefore, pore size and patient comfort are relating directly. Studies have shown that when using lightweight meshes (with adequate strength), patients experience less pain.

Another important consideration in determining pore size is cellular penetration. The Pores smaller than 75 micrometers are more likely to create bacterial colonies and cause infection.

However, the macroporous meshes are the meshes with pore sizes greater than 100 micrometers, allowing for macrophage penetration, new blood vessel formation, and tissue integration.

Furthermore, the pore size increasing of 100 to 300 micrometers improves the formation of new vascular structures and tissue integration. The important note, the pore size increase beyond a certain limit has a detrimental effect and compromises the mesh structure.

These considerations must be considered along with maintaining  full strength, because if the mesh doesn’t enough strength the performance of the mesh will be compromised. Tissue reinforcement may be compromised.