Barbed mesh for incision closure and hernia repair

Abstract

A barbed mesh device is provided for tissue closure and tissue support when the tissue is closed by other means. The device includes a macroporous mesh with a plurality of intersections or apertures and a plurality of barbs extending from the plurality of intersections or apertures on at least one side of the mesh. The plurality of barbs each include a barb body and a plurality of projections extending at an angle from the barb body.

What is claimed is: 
     
         1 . A device for tissue closure, the device comprising:
 a macroporous mesh comprising a plurality of intersections, the macroporous mesh having a first side and a second side;   a first plurality of barbs extending from the plurality of intersections on the first side of the macroporous mesh; and   a second plurality of barbs extending from the plurality of intersections on the second side of the macroporous mesh,   each barb in the first plurality of barbs and the second plurality of barbs comprising:
 a barb body; and 
 a projection extending at an angle from the barb body. 
   
     
     
         2 . The device of  claim 1 , wherein the angle of the projection on each barb of the first plurality of barbs is about 15 degrees to about 90 degrees. 
     
     
         3 . The device of  claim 1 , wherein the angle of the projection on each barb of the second plurality of barbs is about 15 degrees to about 90 degrees. 
     
     
         4 . The device of  claim 1 , wherein the barb body of each barb in the first plurality of barbs has a length longer than a length of the barb body of each barb in the second plurality of barbs. 
     
     
         5 . The device of  claim 1 , wherein the barb body of each barb in the first plurality of barbs has a length of about 5 cm to about 15 cm. 
     
     
         6 . The device of  claim 1 , wherein the barb body of each barb in the second plurality of barbs has a length of about 0.1 cm to about 5 cm. 
     
     
         7 . The device of  claim 1 , wherein the projection on each barb of the first plurality of barbs has a length of about 1 mm to about 2 mm. 
     
     
         8 . The device of  claim 1 , wherein the projection on each barb of the second plurality of barbs has a length of about 0.5 mm to about 1 mm. 
     
     
         9 . The device of  claim 1 , wherein the device is semi-rigid. 
     
     
         10 . The device of  claim 1 , wherein the barb body of each barb in the first plurality of barbs has a diameter larger than a diameter of each barb in the second plurality of barbs. 
     
     
         11 . The device of  claim 1 , wherein the first plurality of barbs, the second plurality of barbs, and the macroporous mesh are fabricated as one unit. 
     
     
         12 . A method of tissue closure, the method comprising:
 approximating edges of an opened tissue;   placing a first side of a device over a broad surface area covering the edges of the opened tissue, the device comprising:
 a macroporous mesh comprising a plurality of intersections, the macroporous mesh having a first side and a second side; 
 a first plurality of barbs extending from the plurality of intersections on the first side of the macroporous mesh; and 
 a second plurality of barbs extending from the plurality of intersections on the second side of the macroporous mesh; and 
   pressing on the device, wherein the first plurality of barbs penetrate and are retained to a first layer of tissue and the second plurality of barbs penetrate and are retained to a second layer of tissue.   
     
     
         13 . The method of  claim 12 , wherein each barb in the first plurality of barbs and the second plurality of barbs comprise:
 a barb body; and   a projection extending at an angle from the barb body.   
     
     
         14 . The method of  claim 13 , the method further comprising trimming the first plurality of barbs and/or the second plurality of barbs so that each barb has a desired length and a desired location for closure of the tissue. 
     
     
         15 . The method of  claim 12 , wherein the device is semi-rigid and reduces tension on the edges of the opened tissue by distributing tension and mechanical strain into the macroporous mesh. 
     
     
         16 . The method of  claim 12 , wherein the method closes tissue transcutaneously, subcutaneously, or trans-facially in an onlay position, in a sublay or retrorectus position, or in an underlay or intra-peritoneal position. 
     
     
         17 . The method of  claim 12 , wherein the method closes tissue along multiple soft tissue planes and reduces shearing of the soft tissue planes by stabilizing and adhering the soft tissue planes to the device. 
     
     
         18 . The method of  claim 12 , wherein the method closes a laparotomy incision, a midline sternal incision, or an abdominoplasty incision. 
     
     
         19 . The method of  claim 12 , wherein the method repairs or prevents an abdominal hernia, closes an incision in soft tissue, supports undermined soft tissue planes, provides three dimensional fixation of soft tissues, enables three dimensional repair of soft tissues, or supports other methods of tissue closure to prevent dehiscence. 
     
     
         20 . The method of  claim 12 , the method further comprising trimming the macroporous mesh to a desired length and width.