TiLENE® Plug Set

Implantation

For indirect hernias, the hernial sac is separated after preparation and ligature.
To ensure optimum results, select the right size of TiLENE® Plug. If necessary, trim the inner fabric of the TiLENE® Plug for smaller defects requiring less mesh fabric. Grasp the inner fabric of the TiLENE® Plug with sterile forceps or clamp and push the plug gently through the internal ring deep into the preperitonaeal space. Once the plug is in position, secure the outer ply of the plug with 2–4 sutures. In addition, the TiLENE® Onlay Patch is placed on the anterior surface of the posterior wall of the inguinal canal. The opening is placed around the spermatic duct in order to repair an additionally existing direct hernia and/or to provide strengthening in order to prevent the recurrence of a direct or indirect hernia.

Titanisation

Chemical vapour deposition (CVD) is a process for the metallisation of complex components while at the same time achieving strong bonds. However, as this process involves temperatures in excess of 150°C, it is not an option for many prosthetic materials which would not be shape retentive at such temperatures (e.g. polypropylene).

For that reason, the titanisation of plastic implants takes place at low temperatures using a special plasma-coating process known as PACVD (plasma-activated chemical vapour deposition).

Plasma is the term used for an excited (ionised) gas. In that stage, atoms/molecules are highly energetic. However, plasma is not hot. In everyday life, we are familiar with plasma in fluorescent tubes. The electrically charged gas components emit light as the result of their highly energetic state, but the fluorescent tube remains cold.

In the titanisation process, gaseous titanium is introduced into the coating chamber as a precursor. By adding energy in form of plasma, the precursor is split into individual ionised atoms. These ionised titanium atoms have free electrons at their surfaces.

In addition to the precursor, the plasma also excites the surfaces of the plastic implants with the result that their surfaces also have free electrons. The ionised titanium atoms come into contact with the ionised surface of the implant resulting in the formation of covalent bonds with the free electrons. Covalent bonds are seen as the strongest of chemical bonds; the titanium is thus almost permanently bonded to the plastic.

This process creates a composite material whose surface is coated with an ultra-thin, approx. 30–50 nm (1 nanometre = 1 millionth of a millimetre), highly biocompatible layer of titanium. The coating is so thin that it appears to be transparent and is also highly flexible.

Because the titanium precursor is introduced in gaseous form, it reaches all parts of the plastic implant. As the result, the entire surface, including gaps in between complex shapes, is completely and evenly titanised.