Surgical mesh is a medical device used to provide structural support to weakened or damaged tissue within the body. This screen-like material is most often employed in procedures like hernia repair, reinforcing the abdominal wall, or in pelvic organ prolapse repair. The question of whether this mesh dissolves depends entirely on the specific material chosen for the surgical repair. The mesh functions as an internal scaffold, but its long-term presence or absence is a deliberate design feature determined by its composition.
Categorizing Surgical Mesh
Surgical mesh is broadly categorized into three types based on its intended permanence within the body. The fundamental distinction for a patient is whether the material is designed to remain indefinitely or to be absorbed over time.
Non-absorbable, or permanent, mesh is typically constructed from synthetic polymers, with polypropylene being the most commonly used material. This type of mesh is a permanent implant, providing long-term reinforcement to the repaired tissue site, such as a hernia.
Absorbable mesh is made from synthetic polymers, such as polyglycolic acid or polycaprolactone, or from biological tissue derived from sources like treated pig or cow dermis. This mesh is not intended for permanent support and will fully dissolve after serving its temporary function.
A third option is composite mesh, which combines both permanent and absorbable components. In this design, a permanent material provides the long-term strength, while an absorbable layer, often a coating, prevents the mesh from adhering to surrounding internal organs.
How Absorbable Mesh Dissolves
Absorbable mesh is specifically engineered to act as a temporary scaffold while the patient’s body builds new, strong tissue. These materials are introduced into the body to provide immediate mechanical support at the repair site.
The degradation of synthetic absorbable mesh occurs through hydrolysis, where water molecules break the polymer chains down into smaller, biocompatible fragments. Biological meshes, conversely, are broken down by the body’s natural enzymatic processes.
As the mesh material is gradually absorbed, its supportive strength diminishes, but this loss is synchronized with the body’s healing process. The body responds by encouraging the growth of native tissue and collagen fibers throughout the scaffold. This new scar tissue formation eventually takes over the supportive role.
The entire process of absorption can range significantly depending on the material. Some products dissolve in as little as six months, while others may take up to three years to be fully reabsorbed and excreted by the body.
The Long-Term Fate of Permanent Mesh
Mesh that does not dissolve, such as that made from polypropylene or expanded polytetrafluoroethylene (ePTFE), remains in the body indefinitely. The intended fate of this permanent material is integration, where the surrounding tissue grows into and around the mesh structure.
The material’s porous nature allows the patient’s own fibroblasts and collagen fibers to infiltrate the weave, effectively anchoring the mesh in place and forming a strong, reinforced tissue layer. This permanent integration provides the long-term mechanical strength necessary to prevent the recurrence of a hernia or prolapse.
While permanent mesh is designed for lifelong use, its continued presence can sometimes lead to long-term issues. The body may mount a chronic inflammatory response, which is a low-grade reaction to the foreign material.
This sustained inflammation can potentially lead to mesh contraction, where the mesh shrinks over time, or chronic pain. In rare instances, the mesh may migrate from its original location or erode into adjacent organs.
The material’s durability means it can last for decades, and for the vast majority of patients, it serves its purpose without complication. However, the potential for a foreign body reaction means that even a successful repair may be associated with the long-term presence of a synthetic substance.