Surgipro mesh: not all multifilaments are the same

Excerpt

Many surgeons believe that the use of multifilament implants should be avoided because they potentiate the development of infection. This is primarily based on historical reports involving very reactive materials. Standardized studies in a mouse model documented that multifilament sutures composed of silk, catgut, and Dacron were very reactive and greatly potentiated the development of infection [1]. Multifilament sutures of the synthetic polymers of nylon and polyglycolic acid were very weak potentiators of infection. In fact, when monofilament nylon sutures were compared to multifilament nylon sutures, there was no significant difference in their susceptibility to infection. Polypropylene sutures, like nylon, were documented to have a low level of infectivity. These results suggested that the chemical composition of the implant was more important than its physical structure in potentiating the development of acute infections; studies from other labs have confirmed these results [2, 3]. Other studies conducted over longer periods have indicated that multifilament sutures have a higher risk of potentiating infection than monofilament sutures [4‐8]. In all of these studies, one of the sutures with the lowest risk of potentiating infection was monofilament polypropylene. No multifilament polypropylene suture is available to evaluate its infection-potentiating effect. …