Technology

DURAMESH- The World's First and Only Suturable Mesh8,11

Suturable Mesh combines the desirable principles of a mesh repair with the placement precision of a suture

Technology

DURAMESH - The World's First and Only Suturable Mesh

Suturable Mesh combines the desirable principles of a mesh repair with the placement precision of a suture

The Problem

Sutures can cut through otherwise intact tissue due to the presence of a sharp leading edge - described as "suture pull-through" or "cheese-wiring" - leading to repair failure.

Meshes better distribute forces to limit tissue tearing, but they introduce their own complications, such as chronic pain, adhesions, fistulas, migration, and infection.

A device is needed that both distributes forces without introducing mesh-related complications.

Suture Pull-Through Can Cut Intact Tissue

Sutures can cut through otherwise intact tissue due to the presence of a sharp leading edge - described as "suture pull-through" or "cheese-wiring" - leading to repair failure.

Meshes distribute forces and allow for tissue ingrowth.


The Best of Both Worlds

Duramesh combines the desirable principles of a mesh repair with the placement precision of a suture.

A Best of Both Worlds Solution - Suturable Mesh

Suturable Mesh combines the desirable principles of a mesh repair with the placement precision of a suture. It is the world's only device that both approximates tissue and permits ingrowth for a stronger, earlier repair.3

It is the world's only device that both approximates tissue and permits ingrowth for a strong early repair.12


Innovative Design to Distribute Forces

Duramesh has more surface area to distribute forces.5 

Innovative Design to Distribute Forces

Duramesh's patented design has more surface area than standard sutures to distribute forces and reduce suture pull-through.1 Unlike standard sutures, Duramesh flattens to better distribute forces at the suture-tissue interface.2 

Duramesh flattens to better distribute forces at the suture-tissue interface.7 


Allows Tissue Incorporation10

Durameshhas an open-walled, hollow core design to allow tissue incorporation of the device during healing.10

Allows Tissue Incorporation2

Duramesh's filaments flatten parallel to the incision, and its open-walled, hollow core design allows tissue incorporation into the device during healing.


DURAMESH's Dynamic Diameter

Duramesh's diameter decreases with axial tension so that it can be passed through tissue easily (see Diameter vs Load).5

Duramesh's Dynamic Diameter

Duramesh's diameter decreases with axial tension so that it can be passed through tissue easily.


Easy to Handle, Use, and Tie

Duramesh's handling and use are similar to those of a standard suture.5

Duramesh's novel design allows it to collapse when tied, resulting in a low-profile knot as compared to its outsized diameter.5 In knot size and knot strength testing, Duramesh knots were shown to be stronger than standard suture knots for the same number of throws.5

Duramesh requires at least 4 alternating throws for a secure, low-profile knot.5


A Stronger, Earlier Repair3

Repairs with Duramesh revealed less gap formation and more intact repairs in comparison to conventional sutures in an in-vivo rabbit tendon model. Duramesh repairs were twice as strong as standard suture at two weeks.

A Strong Early Repair12

Duramesh minimizes gap formation and allows for tissue ingrowth and implant incorporation. (see Explanted Tendon Outcome)7


1. Incisional Hernia Rate 3 Years after Midline Laparotomy

C Fink, P Baumann, M N Wente, P Knebel, T Bruckner, A Ulrich, J Werner, M W Büchler, M K Diener, Incisional hernia rate 3 years after midline laparotomy, British Journal of Surgery, Volume 101, Issue 2, January 2014, Pages 51–54, https://doi.org/10.1002/bjs.9364

2. Incisional Hernia Rates following Midline Laparotomy in the Obese Patient: a Retrospective Review

Wehrle CJ, Shukla P, Miller BT, Blake KE, Prabhu AS, Petro CC, Krpata DM, Beffa LR, Tu C, Rosen MJ. Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review. Hernia. 2023 Jun;27(3):557-563. doi: 10.1007/s10029-022-02688-6. Epub 2022 Nov 1. PMID: 36318389.

3. Long-Term Follow-Up of a Randomized Controlled Trial of Suture versus Mesh Repair of Incisional Hernia

Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004 Oct;240(4):578-83; discussion 583-5. doi: 10.1097/01.sla.0000141193.08524.e7. PMID: 15383785; PMCID: PMC1356459.

4. Long-Term Outcomes of Massive Rotator Cuff Tear Repair: A Systematic Review

Shah NS, Suriel Peguero E, Umeda Y, Crawford ZT, Grawe BM. Long-Term Outcomes of Massive Rotator Cuff Tear Repair: A Systematic Review. HSS J. 2022 Feb;18(1):130-137. doi: 10.1177/15563316211008137. Epub 2021 Apr 15. PMID: 35087343; PMCID: PMC8753535.

5. Internal Product Testing

6. Experimental Study of the Characteristics of a Novel Mesh Suture 

G A Dumanian, A Tulaimat, Z P Dumanian, Experimental study of the characteristics of a novel mesh suture, British Journal of Surgery, Volume 102, Issue 10, September 2015, Pages 1285–1292, https://doi.org/10.1002/bjs.9853

7. Biomechanical Properties of a Novel Mesh Suture in a Cadaveric Flexor Tendon Repair Model 

Wallace SJ, Mioton LM, Havey RM, Muriuki MG, Ko JH. Biomechanical Properties of a Novel Mesh Suture in a Cadaveric Flexor Tendon Repair Model. J Hand Surg Am. 2019 Mar;44(3):208-215. doi: 10.1016/j.jhsa.2018.11.016. Epub 2019 Jan 16. PMID: 30660397.

8. Advances, challenges, and prospects for surgical suture materials

Yiran Li, Qi Meng, Shaojuan Chen, Peixue Ling, Mitchell A. Kuss, Bin Duan, Shaohua Wu, Advances, challenges, and prospects for surgical suture materials, Acta Biomaterialia, Volume 168, 2023, Pages 78-112,ISSN 1742-7061,

9. [Mesh Suture] Better Resists Early Laparotomy Failure in a Cyclic Ball-Burst Model

Scheiber CJ, Kurapaty SS, Goldman SM, Dearth CL, Liacouras PC, Souza JM. Suturable mesh better resists early laparotomy failure in a cyclic ball-burst model. Hernia. 2020 Jun;24(3):559-565. doi: 10.1007/s10029-020-02133-6. Epub 2020 Feb 10. PMID: 32040788.

10. [Mesh Suture] Demonstrates Improved Outcomes over Standard Suture in a Porcine Laparotomy Closure Model

Dumanian GA. Suturable Mesh Demonstrates Improved Outcomes over Standard Suture in a Porcine Laparotomy Closure Model. Plast Reconstr Surg Glob Open. 2021 Oct 15;9(10):e3879. doi: 10.1097/GOX.0000000000003879. PMID: 34667699; PMCID: PMC8519206.

11. Duramesh Registry Study: Short-Term Outcomes using mesh suture for Abdominal Wall Closure

Hackenberger PN, Mittal M, Fronza J, Shapiro M. Duramesh registry study: short-term outcomes using mesh suture for abdominal wall closure. Front Surg. 2024 Jan 11;10:1321146. doi: 10.3389/fsurg.2023.1321146. PMID: 38274351; PMCID: PMC10809794.

12. Novel Mesh Suture Versus Traditional Suture-Based Repair in a Rabbit Tendon Model

Janes LE, Mioton LM, Fracol ME, Ko JH. An In Vivo Comparison: Novel Mesh Suture Versus Traditional Suture-Based Repair in a Rabbit Tendon Model. J Hand Surg Glob Online. 2021 Nov 19;4(1):32-39. doi: 10.1016/j.jhsg.2021.10.003. PMID: 35415598; PMCID: PMC8991626.

Sutures Can Cut Intact Tissue

Sutures can cut through otherwise intact tissue due to the presence of a sharp leading edge - described as "suture pull-through" or "cheese-wiring" - leading to repair failure.

Meshes distribute forces and allow for tissue ingrowth.

The Problem

Sutures can cut through otherwise intact tissue due to the presence of a sharp leading edge - described as "suture pull-through" or "cheese-wiring" leading to repair failure.

Meshes better distribute forces to limit tissue tearing, but they introduce their own complications, such as chronic pain, adhesions, fistulas, migration, and infection.


A Best of Both Worlds Solution - Suturable Mesh

Suturable Mesh combines the desirable principles of a mesh repair with the placement precision of a suture.

The Best of Both Worlds

Duramesh combines the desirable principles of a mesh repair with the placement precision of a suture. It is the world's first device that both approximates tissue and allows ingrowth for a strong early repair.3

It is the world's only device that both approximates tissue and permits ingrowth for a stronger, earlier repair.3


Innovative Design to Distribute Forces

Duramesh's patented design has more surface area than standard sutures to distribute forces and reduce suture pull-through.1 

Innovative Design to Distribute Forces

Duramesh has more surface area to distribute forces.5 Duramesh flattens to better distribute forces at the suture-tissue interface.7 


Allows Tissue Incorporation2

Duramesh's filaments flatten parallel to the incision, and its open-walled, hollow core design allows tissue incorporation into the device during healing.

Allows Tissue Incorporation10

Duramesh has an open-walled, hollow core design to allow tissue incorporation of the device during healing.10


Duramesh's Dynamic Diameter

Duramesh's diameter decreases with axial tension so that it can be passed through tissue easily.

DURAMESH's Dynamic Diameter

Duramesh's diameter decreases with axial tension so that it can be passed through tissue easily (see Diameter vs Load)5


Easy to Handle, Use, and Tie

Duramesh's handling and use are similar to those of a standard suture.5

Duramesh's novel design allows it to collapse when tied, resulting in a low-profile knot as compared to its outsized diameter.5 In knot size and knot strength testing, Duramesh knots were shown to be stronger than standard suture knots for the same number of throws.5

Duramesh requires at least 4 alternating throws for a secure, low-profile knot.5


A Strong Early Repair12

Duramesh minimizes gap formation and allows for tissue ingrowth and implant incorporation (see Expl7

A Stronger, Earlier Repair3

Repairs with Duramesh revealed less gap formation and more intact repairs in comparison to conventional sutures in an in-vivo rabbit tendon model. Duramesh repairs were twice as strong as standard suture at two weeks.


References

1. Incisional Hernia Rate 3 Years after Midline Laparotomy

C Fink, P Baumann, M N Wente, P Knebel, T Bruckner, A Ulrich, J Werner, M W Büchler, M K Diener, Incisional hernia rate 3 years after midline laparotomy, British Journal of Surgery, Volume 101, Issue 2, January 2014, Pages 51–54, https://doi.org/10.1002/bjs.9364

2. Incisional Hernia Rates following Midline Laparotomy in the Obese Patient: a Retrospective Review

Wehrle CJ, Shukla P, Miller BT, Blake KE, Prabhu AS, Petro CC, Krpata DM, Beffa LR, Tu C, Rosen MJ. Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review. Hernia. 2023 Jun;27(3):557-563. doi: 10.1007/s10029-022-02688-6. Epub 2022 Nov 1. PMID: 36318389.

3. Long-Term Follow-Up of a Randomized Controlled Trial of Suture versus Mesh Repair of Incisional Hernia

Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004 Oct;240(4):578-83; discussion 583-5. doi: 10.1097/01.sla.0000141193.08524.e7. PMID: 15383785; PMCID: PMC1356459.

4. Long-Term Outcomes of Massive Rotator Cuff Tear Repair: A Systematic Review

Shah NS, Suriel Peguero E, Umeda Y, Crawford ZT, Grawe BM. Long-Term Outcomes of Massive Rotator Cuff Tear Repair: A Systematic Review. HSS J. 2022 Feb;18(1):130-137. doi: 10.1177/15563316211008137. Epub 2021 Apr 15. PMID: 35087343; PMCID: PMC8753535.

5. Internal Product Testing

6. Experimental Study of the Characteristics of a Novel Mesh Suture 

G A Dumanian, A Tulaimat, Z P Dumanian, Experimental study of the characteristics of a novel mesh suture, British Journal of Surgery, Volume 102, Issue 10, September 2015, Pages 1285–1292, https://doi.org/10.1002/bjs.9853

7. Biomechanical Properties of a Novel Mesh Suture in a Cadaveric Flexor Tendon Repair Model 

Wallace SJ, Mioton LM, Havey RM, Muriuki MG, Ko JH. Biomechanical Properties of a Novel Mesh Suture in a Cadaveric Flexor Tendon Repair Model. J Hand Surg Am. 2019 Mar;44(3):208-215. doi: 10.1016/j.jhsa.2018.11.016. Epub 2019 Jan 16. PMID: 30660397.

8. Advances, challenges, and prospects for surgical suture materials

Yiran Li, Qi Meng, Shaojuan Chen, Peixue Ling, Mitchell A. Kuss, Bin Duan, Shaohua Wu, Advances, challenges, and prospects for surgical suture materials, Acta Biomaterialia, Volume 168, 2023, Pages 78-112,ISSN 1742-7061,

9. [Mesh Suture] Better Resists Early Laparotomy Failure in a Cyclic Ball-Burst Model

Scheiber CJ, Kurapaty SS, Goldman SM, Dearth CL, Liacouras PC, Souza JM. Suturable mesh better resists early laparotomy failure in a cyclic ball-burst model. Hernia. 2020 Jun;24(3):559-565. doi: 10.1007/s10029-020-02133-6. Epub 2020 Feb 10. PMID: 32040788.

10. [Mesh Suture] Demonstrates Improved Outcomes over Standard Suture in a Porcine Laparotomy Closure Model

Dumanian GA. Suturable Mesh Demonstrates Improved Outcomes over Standard Suture in a Porcine Laparotomy Closure Model. Plast Reconstr Surg Glob Open. 2021 Oct 15;9(10):e3879. doi: 10.1097/GOX.0000000000003879. PMID: 34667699; PMCID: PMC8519206.

11. Duramesh Registry Study: Short-Term Outcomes using mesh suture for Abdominal Wall Closure

Hackenberger PN, Mittal M, Fronza J, Shapiro M. Duramesh registry study: short-term outcomes using mesh suture for abdominal wall closure. Front Surg. 2024 Jan 11;10:1321146. doi: 10.3389/fsurg.2023.1321146. PMID: 38274351; PMCID: PMC10809794.

12. Novel Mesh Suture Versus Traditional Suture-Based Repair in a Rabbit Tendon Model

Janes LE, Mioton LM, Fracol ME, Ko JH. An In Vivo Comparison: Novel Mesh Suture Versus Traditional Suture-Based Repair in a Rabbit Tendon Model. J Hand Surg Glob Online. 2021 Nov 19;4(1):32-39. doi: 10.1016/j.jhsg.2021.10.003. PMID: 35415598; PMCID: PMC8991626.