ULTRAPRO™

Designed to help restore

patients back to their pre-
hernia life

RANIA RAMADAN
COUNTRY HERNIA
SPECIALISYT

TR124TR 124 ©Johnson & Johnson Medical Limited 2013 1

What Makes A Mesh?

• Mesh Construction –
Variables:
– WEAVE / CONSTRUCTION
» Pore size & configuration
– FILAMENT SIZE
» Diameter of the fibers used to
create the mesh
– COMPONENTS
» Choice of absorbable or non-
absorbable materials
Pore Size & Scar Tissue?

Inelastic, rigid tissue scar plate can form.

The larger pore construction reduces connective tissue foreign body reaction by maximising
areas not in contact with the foreign body. Also increases elasticity properties.

foreign body scar tissue

Mesh Categories
Heavy Weight
(Small Pore)
Meshes

Light Weight
(Large Pore)
Meshes

MPPAM
(Macro Porous
Partial Absorbable
Meshes)

4
ULTRAPRO* Mesh

Designed to help
restore patients
back to their pre-
hernia life
Characteristics of the new Mesh generation
Macroporous
PARTIALLY ABSORBABLE
CONCEPT
Thinner
‘MPPAM ‘
filament
Absorbabl
Minimal physiologic
tensile strength of 16
Larger e
- 32 N/cm Pore Size Compone
Made of nt
Polypropylene to Reduce the
amount of
Elasticity of 20 – 35 % : foreign body
implanted for
Stretchable lifetime
Physiology and
mechanics of the
abdominal wall
Optimized foreign
body reaction
 ULTRAPRO* Mesh
• Large Pore Size
– 3-4 mm pore size (3000-4000µm)
– induces ingrowth of collagen fiber network
– Improved visibility through the mesh

• Thin Filaments
– 0.5mm filaments of monofilament MONOCRYL* suture & PROLENE* mesh twisted
together and yarns knitted to form composite mesh structure

• Absorbable Component
– Approx. 50% MONOCRYL* suture & 50% PROLENE* Mesh in mass
– MONOCRYL functions to make construction stiffer for better handling
– Absorbed in 84 days

• Lightweight
– 65% less permanently implanted residual mass than PROLENE* Mesh

Data on File ETHICON

 ULTRAPRO* Mesh benefits

• 65% less foreign body implant while maintaining sufficient abdominal wall
strength (4x maximum pressure)

• Designed for excellent tissue in-growth and a secure repair

• Forms strong and flexible scar tissue and promotes natural abdominal
wall mobility

• Allows for clear visualization of the anatomy and improved handling

during placement

• Less inflammation than traditional weight PP mesh may result in less

contraction
Cobb WS The Argument for Lightweight Mesh in Hernia Repair Surgical Innovation
March 2005
 Improved Intraoperative Handling

– MONOCRYL™ 6-0 fibers components

» Added stiffness for improved surgical handling (2)

» MONOCRYL™ fully absorbed through hydrolysis in
approximately 84 days after implantation (2)

– Easy of handling with blue stripes to indicate correct placement

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9
 MPPAM* vs Prolene*

Mesh Type Area Thickness Pore Size Maximum Burst

Weight Strength
g/m² mm mm mmHg %
VYPRO out-of-pack 55 0.5 4-5
VYPRO in-situ 25 0.39 300-375 31%
VYPRO II out-of-pack 75 0.5 3-4
VYPRO II in-situ 30 0.39 338-413 20-28%
ULTRAPRO out-of-pack 50-55 0.5 3-4
ULTRAPRO in-situ 28 0.5 450-600 15-20%
PROLENE Soft 45 0.42 2 675-750 ~20%
PROLENE 80-85 0.6 1 1500-1763 8%
MERSILENE 33-43 0.23-0.26 1 338-525 16%
Comparison of Abdominal pressure with mesh
burst strength

1650
1500
Pressure (mmHg)

1000
700
620 650
500 430
4 13 44 59 110 150
0

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ULTRAPRO™ - An efficient solution for your
department
• All tension-free techniques of inguinal hernia surgery
according to Lichtenstein, TAPP or TEP(4)

• Also available as Hernia Device or Plug

• Incisional hernia treatment, in an extraperitoneally

position, preferably in retromuscular plane (Sublay) (4)

• ULTRAPRO™ mesh can be simply cut into

the shape required(4)

TR124TR 124 ©Johnson & Johnson Medical Limited 2013 1

Long-term stability for your patients with ULTRAPRO™

• PROLENE™ 5-0 filaments

» PROLENE™ is used for more than 50 years in various specialties
» No degeneration to ensure long term stability and durability (3)
• Mesh weaven pattern
» Resist twice the maximum abdominal pressure (> 650 mm Hg) (2)
Pressure (mm Hg)

Maximum abdominal pressure

Comparison of abdominal pressure with mesh burst strength (14,16)

TR124TR 124 ©Johnson & Johnson Medical Limited 2013

1
Thin monofilament components reduce the risk of
infection for safe healing(1)

• ULTRAPRO™ mesh construction

» Macroporous design promotes fluid flow-through & reduces risk of
seromas that could lead to infection (17,18)

• ULTRAPRO™ mesh components

» MONOCRYL™ 6-0 (~50%)(4)
» PROLENE™ 5-0 (~50%)(4)

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1
 Increased comfort & flexibility for your patients
(2,13,14,15)

Macroporous partially absorbable ULTRAPRO™ Mesh displays

Meshes are advantageous for multidirectional elasticity
abdominal wall function(7)
8

6
1/100 cm

0
Control Mesh1 Mesh2 MPPAM

<4 Months >4 Months

Mean curvature of the abdominal wall after Mesh Demonstration of ULTRAPRO™ Mesh
implantation measured by 3D stereography (7) elasticity in vivo (PD Joachim Conze, Germany
(6))

TR124TR 124 ©Johnson & Johnson

 ULTRAPRO™ - Designed to improve patient comfort
(10,13,15)

ULTRAPRO™ Mesh caused less interference with physical activities than

heavyweight Mesh at month 4 and/or 15 (12)

Activity “limits a little” Activity “very limiting”

N = 150 N = 160
Patients reporting
impairment (%)

* P<0,05
ULTRAPRO™ - Fact Sheet

Category ULTRAPRO™

Resist twice the maximum

Tensile strength
abdominal pressure (2)

Mesh elasticity at 16 N/cm Multidirectional elasticity

Effective porosity: 61% (8)

Effective porosity
Macroporous – Pore size > 3 mm (2)

Material PROLENE™ 5-0 and MONOCRYL™ 6-0

Weight 28 g/m² after absorption of MONOCRYL™ (2)

MONOCRYL™ used to stiffen the mesh structure

Handling
for secure and easy handling (4)
Shrinkage Shrinkage of only 1.9% (11)

TR124TR 124 ©Johnson & Johnson

Medical Limited 2013
ULTRAPRO* Mesh Sizes
1 & 3 per
UMS1/3 6X11cm
box
1 & 3 per
UMN1/3 15X10cm
box
1 & 3 per
UMN1/3 15X15cm
box
UML1 30X30cm 1 per box
UMT1 30X15cm 1 per box
UMF1 15X17cm 1 per box