Physical Characteristics of Medical Textile Prostheses Designed for Hernia Repair: A Comprehensive Analysis of Select Commercial Devices

Inguinal hernia repairs are among the most frequent operations performed worldwide. This study aims to provide further understanding of structural characteristics of hernia prostheses, and better comprehensive evaluation. Weight, porosity, pore size and other physical characteristics were evaluated; warp knitting structures were thoroughly discussed. Two methods referring to ISO 7198:1998, i.e., weight method and area method, were employed to calculate porosity. Porosity ranged from 37.3% to 69.7% measured by the area method, and 81.1% to 89.6% by the weight method. Devices with two-guide bar structures displayed both higher porosity (57.7%-69.7%) and effective porosity (30.8%-60.1%) than single-guide bar structure (37.3%-62.4% and 0%-5.9%, respectively). Filament diameter, stitch density and loop structure combined determined the thickness, weight and characteristics of pores. They must be well designed to avoid zero effective porosity regarding a single-bar structure. The area method was more effective in characterizing flat sheet meshes while the weight method was perhaps more accurate in describing stereoscopic void space for 3D structure devices. This article will give instructive clues for engineers to improve mesh structures, and better understanding of warp knitting meshes for surgeons.