Comparison of mersilene mesh-methyl metacrylate sandwich and polytetrafluoroethylene grafts for chest wall reconstruction

J Invest Surg. 2006 Nov-Dec;19(6):353-60. doi: 10.1080/08941930600985694.

Abstract

We report the outcomes of patients who underwent reconstruction with Mersilene mesh-methyl methacrylate (MM-MM) sandwich and polytetrafluoroethylene (PTFE) grafts after a large chest wall resection. Between June 1990 and September 2001, 59 consecutive patients (37 men, 22 women; mean age, 48.1 +/- 11.8 years; range 22-74 years) underwent large chest wall resection (greater than 5 cm diameter) and reconstruction with prosthetic material in our department. Twenty-one patients (33%) underwent reconstruction with a PTFE graft (group 2) between 1990 and 1994, and 38 patients (67%) underwent reconstruction with an MM-MM sandwich graft (group 1) between 1994 and 2001. Operative morbidity ratios were 5.2% (2/38) in group 1 and 24% (5/21) in group 2 (p = .036). The paradoxical respiration ratio was significantly higher (p = .018) in group 2 (5/21: 24%) than it was in group 1 (1/38: 2.6%). The operative mortality ratio was 4.5% (1/21) in group 2 and 0% in group 1. Mean hospital stay was 10.6 days (range 5-21 days) in group 1 and 13.3 days (range 7-36 days) in group 2 (p = .015). The MM-MM graft is inexpensive and easy to apply, provides better cosmetic options, and offers minimal morbidity. We therefore recommend that the MM-MM sandwich graft be used rather than the PTFE graft for large defects of the anterolateral chest wall and sternum where successful prevention of paradoxical respiration is required.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Bioprosthesis* / adverse effects
  • Bioprosthesis* / economics
  • Female
  • Health Care Costs
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Methylmethacrylate*
  • Middle Aged
  • Polyethylene Terephthalates*
  • Polytetrafluoroethylene*
  • Postoperative Complications / mortality
  • Prosthesis Implantation*
  • Retrospective Studies
  • Surgical Mesh* / adverse effects
  • Surgical Mesh* / economics
  • Thoracic Wall / surgery*
  • Treatment Outcome

Substances

  • Polyethylene Terephthalates
  • Methylmethacrylate
  • Lavsan
  • Polytetrafluoroethylene