Authors : Stefan Farke , Andreas Paech , Michael Duchrow , Tobias Bethge , Thilo Wedel , Buko Lindner , Uwe J. Roblick , Hans-Peter Bruch and Rainer Broll
Abstract: In times of reduced financial margins, resterialization of surgical meshes is a possibility to economise their use. To test whether re-sterilization of polypropylene meshes (initially gas-sterilized) by steam autoclaving is advisable we analyzed resterilized specimens on structural alterations and the release of cytotoxic substances. Gas-sterilized (non-resterilized) and resterilized (121°C, 20 min) nonabsorbable PROLENE (Ethicon, Germany) meshes (1 cm2) incubated 48 h under cell culture conditions were imaged using scanning electron microscopy. Potential release of substances from original and resterilized meshes was analyzed on lyophilisates using mass spectrometry. Toxicity of lyophilisates was tested on cultures of primary fibroblasts by estimation of proliferation and apoptotic index. Original meshes showed a smooth surface. Filaments of resterilized meshes exhibited tears and crevices of variable depth. After incubation under cell culture conditions, filaments of non-resterilized and especially resterilized meshes revealed tears and crevices. Dots of variable size have formed on the surface. Mass spectrograms of resterilized meshes demonstrated release of polymer molecules with a mass difference of 44 amu. Finally, apoptotic index of fibroblasts incubated with lyophilisates of resterilized meshes was significantly elevated. Re-sterilization of polypropylene meshes leads to distinct material defects on filament`s surface and a release of substances which causes apoptosis in human fibroblasts. For this reason, re-sterilization of polypropylene meshes should be avoided.
Stefan Farke , Andreas Paech , Michael Duchrow , Tobias Bethge , Thilo Wedel , Buko Lindner , Uwe J. Roblick , Hans-Peter Bruch and Rainer Broll , 2008. Re-Sterilization of Surgical Polypropylene Meshes: Should it be Done? . Research Journal of Medical Sciences, 2: 7-12.