-
Irish Journal of Medical Science Nov 2019Increasing awareness and regulatory body attention is directed towards the insertion of synthetic material for a variety of surgical procedures. This review aims to... (Review)
Review
INTRODUCTION
Increasing awareness and regulatory body attention is directed towards the insertion of synthetic material for a variety of surgical procedures. This review aims to assess current evidence regarding systemic and auto-immune effects of polypropylene mesh insertion in hernia repair.
METHODS
The electronic literature on systemic and auto-immune effects associated with mesh insertion was examined.
RESULTS
Foreign body reaction following mesh implantation initiates an acute inflammatory cellular response. Involved markers such as IL-1, IL-6, IL-10 and fibrinogen are increased in circulation in the presence of mesh but return to normal at 7 days post operatively. Oxidative degradation of implanted mesh is likely, but no evidence exists to support systemic absorption or resulting disease effects. Variable cytokine production in healthy hosts leading to unpredictable or overwhelming response to implanted biomaterial warrants further investigation. Clinical studies show no associated long-term systemic effects with mesh.
CONCLUSION
To date, there remains no evidence to link polypropylene mesh and systemic or auto-immune symptoms. Based on current evidence, the use of polypropylene mesh is supported.
Topics: Biomarkers; Foreign-Body Reaction; Hernia, Inguinal; Herniorrhaphy; Humans; Inflammation; Polypropylenes; Prostheses and Implants; Surgical Mesh
PubMed: 30915679
DOI: 10.1007/s11845-019-02008-5 -
Ophthalmology Sep 1981Polypropylene is a polymer widely used in lens implantation, both as a loop material and as an intracameral suture. The chemistry and qualities of this material are...
Polypropylene is a polymer widely used in lens implantation, both as a loop material and as an intracameral suture. The chemistry and qualities of this material are discussed. Predicated on its usage in other types of surgery, it appears to be resistant to degradation. However, reports have suggested that it may degrade when exposed to high levels of ultraviolet radiation. This would not be a consideration in internal organs, but the eye is a unique case, and the matter should be studied further.
Topics: Animals; Chemical Phenomena; Chemistry; Lenses, Intraocular; Ophthalmologic Surgical Procedures; Polypropylenes; Rabbits; Sutures; Ultraviolet Rays
PubMed: 7301312
DOI: 10.1016/s0161-6420(81)80012-7 -
Journal - American Intra-Ocular Implant... Oct 1978
Topics: Evaluation Studies as Topic; Lenses, Intraocular; Plastics; Polypropylenes; Ultraviolet Rays
PubMed: 748315
DOI: 10.1016/s0146-2776(78)80084-6 -
The Journal of Urology Jul 2012We reviewed the mechanisms by which polypropylene mesh changes after implantation in the human body. (Review)
Review
PURPOSE
We reviewed the mechanisms by which polypropylene mesh changes after implantation in the human body.
MATERIALS AND METHODS
The existing polymer and medical literature was reviewed regarding polypropylene, including its chemical characteristics, and compositional and physical properties, which undergo alteration after implantation at various human body locations. We also reviewed the changes in those physical properties that were demonstrable in explanted specimens.
RESULTS
Polypropylene in mesh form is commonly considered inert and without adverse reactions after implantation in humans. The literature suggests otherwise with reports of various degrees of degradation, including depolymerization, cross-linking, oxidative degradation by free radicals, additive leaching, hydrolysis, stress cracking and mesh shrinkage along with infection, chronic inflammation and the stimulation of sclerosis. Many substances added to polypropylene for various purposes during manufacture behave as toxic substances that are released during the degradation process. The material may also absorb various substances. These alterations in the chemical structure of polypropylene are responsible for visibly demonstrable fiber changes, resulting in the loss of structural integrity through material embrittlement. The heat of manufacturing polypropylene fibers begins the degradation process, which is augmented by the post-production heat used to flatten the mesh to prevent curling and attach anchoring appendages.
CONCLUSION
Based on available evidence the polypropylene used for surgical treatment of various structural defects is not inert after implantation in the human body. The quest for the perfect mesh must continue.
Topics: Foreign-Body Reaction; Humans; Materials Testing; Polypropylenes; Postoperative Period; Surgical Mesh; Urologic Diseases; Urologic Surgical Procedures
PubMed: 22578730
DOI: 10.1016/j.juro.2012.02.2559 -
Ophthalmology Jul 2023
Topics: Humans; Scleritis; Polypropylenes; Sutures
PubMed: 36100503
DOI: 10.1016/j.ophtha.2022.08.008 -
Journal of Materials Chemistry. B Feb 2020Herein, a versatile bilayer system, composed by a polypropylene (PP) mesh and a covalently bonded poly(N-isopropylacrylamide) (PNIPAAm) hydrogel, is reported. The cell...
Herein, a versatile bilayer system, composed by a polypropylene (PP) mesh and a covalently bonded poly(N-isopropylacrylamide) (PNIPAAm) hydrogel, is reported. The cell adhesion mechanism was successfully modulated by controlling the architecture of the hydrogel in terms of duration of PNIPAAm grafting time, crosslinker content, and temperature of material exposure in PBS solutions (below and above the LCST of PNIPAAm). The best in vitro results with fibroblast (COS-1) and epithelial (MCF-7) cells was obtained with a mesh modified with a porous iPP-g-PNIPAAm bilayer system, prepared via PNIPAAm grafting for 2 h at the lowest N,N'-methylene bis(acrylamide) (MBA) concentration (1 mM). Under these conditions, the detachment of the fibroblast-like cells was 50% lower than that of the control, after 7 days of cell incubation, which represents a high de-adhesion of cells in a short period. Moreover, the whole system showed excellent stability in dry or wet media, proving that the thermosensitive hydrogel was well adhered to the polymer surface, after PP fibre activation by cold plasma. This study provides new insights on the development of anti-adherent meshes for abdominal hernia repair.
Topics: Cell Adhesion; Cells, Cultured; Hernia, Abdominal; Humans; Materials Testing; Particle Size; Polypropylenes; Surface Properties; Surgical Mesh
PubMed: 31939983
DOI: 10.1039/c9tb02537e -
Medical Device Technology Jun 1993Polypropylene has a range of properties that make it suitable for use in the manufacture of health care products. These properties can be varied to suit different... (Review)
Review
Polypropylene has a range of properties that make it suitable for use in the manufacture of health care products. These properties can be varied to suit different applications and this has led to its increasing market share in the health care sector. This article discusses recent developments in polypropylene technology and some new applications, highlighting the benefits of polypropylene over the more traditional materials.
Topics: Equipment and Supplies; Humans; Medical Laboratory Science; Polypropylenes
PubMed: 10148793
DOI: No ID Found -
Applied and Environmental Microbiology Dec 2023PP biodegradation has not been clearly shown (it has been uncertain whether the PP structure is actually biodegraded or not). This is the first report on the obvious...
PP biodegradation has not been clearly shown (it has been uncertain whether the PP structure is actually biodegraded or not). This is the first report on the obvious biodegradation of PP. At the same time, this study shows that bacteria could be major degraders of PP in mesopelagic environments. Moreover, PP biodegradation has been investigated by using solid PP as the sole carbon source. However, this study shows that PP would not be used as a sole carbon and energy source. Our data thus provide very important and key knowledge for PP bioremediation.
Topics: Polypropylenes; Alcanivoraceae; Bacteria; Biodegradation, Environmental; Carbon; Plastics
PubMed: 37982621
DOI: 10.1128/aem.01365-23 -
IARC Monographs on the Evaluation of... Feb 1979
Topics: Alkenes; Animals; Carcinogens; Chemical Phenomena; Chemistry; Humans; Industry; Plastics; Polypropylenes; Rats
PubMed: 285918
DOI: No ID Found -
Best Practice & Research. Clinical... Aug 2018In both hernia repair and pelvic organ prolapse surgery, polypropylene (PP) meshes are increasingly used. Although these technologies offer tremendous clinical benefits,... (Review)
Review
In both hernia repair and pelvic organ prolapse surgery, polypropylene (PP) meshes are increasingly used. Although these technologies offer tremendous clinical benefits, the efficacy of these implants can be hindered by the body's immunologic reaction to the implanted material. Undesirable local effects such as chronic pain have been extensively described. Systemic effects, however, are not yet reported. Because systemic effects after implantation of other biomaterials have been described, we evaluated patients with implanted PP meshes for signs and symptoms of biomaterial-related systemic illnesses. Patients referred to an Autoimmunity Clinic between January 2014 and December 2017 were analyzed. In 40 patients, mesh implants were present. These patients were evaluated for the development of a systemic illness. Thirty-two consecutive women and eight men were included in the current study. Median age at the time of operation was 49.5 years (range, 28-75 years). Eighteen patients had a hernia repair and 22 patients had a vaginal mesh implant. Thirty-nine of 40 patients presented with chronic fatigue, and 38 of 40 patients had myalgia or muscle weakness. In most patients, these symptoms started shortly after the operation. All patients fulfilled the diagnostic criteria for autoinflammatory/autoimmunity syndrome induced by adjuvants (ASIA). In addition, most patients reported localized pain and (often-invalidating) irritable bowel syndrome. One quarter of the patients had an immunodeficiency, whereas a diagnosis of well-established systemic and/or localized autoimmune diseases was made in 45% of patients. Importantly, 75% of patients had a pre-existing allergic disease. In 6 patients, the hernia mesh could be completely removed, thereby resulting in (partial) recovery of the systemic disease. In conclusion, 40 patients developed symptoms of a systemic illness after a mesh operation. All patients fulfilled the diagnostic criteria for ASIA. One quarter of the patients had an immunodeficiency, whereas in approximately half of the patients, an autoimmune disease developed. We postulate that PP mesh implants may increase the risk of developing (auto)immune diseases by acting as an adjuvant.
Topics: Adult; Aged; Autoimmunity; Female; Humans; Male; Middle Aged; Polypropylenes; Surgical Mesh; Syndrome
PubMed: 31174820
DOI: 10.1016/j.berh.2019.01.003