Abstract
ObjectivesSynthetic mesh surgery for both abdominal and urogenital hernia repair is often unsatisfactory in the long-term due to postoperative complications. We hypothesized that a semi-degradable mesh hybrid may provide more appropriate biocompatibility with comparable mechanical properties. The aim was to compare its in vivo biocompatibility with a commercial polypropylene (PP) mesh.Methods72 rats were randomly allocated to either our new composite mesh (monofilament PP mesh knitted with polylactic-acid-fibers (PLA)) or to a commercially available PP mesh that was used as a control. 15, 90, and 180 days after implantation into the rat abdomen mesh tissue complexes were analysed for erosion, contraction, foreign body reaction, tissue integration and biomechanical properties.ResultsNo differences were seen in regard to clinical parameters including erosion, contraction or infection rates between the two groups. Biomechanical properties including breaking load, stiffness and deformation did not show any significant differences between the different materials at any timepoint. Macrophage staining did not reveal any significant differences between the two groups or between timepoints either. In regard to collagen I there was significantly less collagen I in the PP group compared to the PP/ PLA group at day 180. Collagen III did not show any significant differences at any timepoint between the two groups.ConclusionA PP/PLA hybrid mesh, leaving a low amount of PP after PLA degradation seems to have comparable biomechanical properties like PP at 180 days due to enhanced collagen production without significant differences in erosion, contraction, herniation or infection rates.
Highlights
Incisional ventral hernias are common side effects after abdominal surgery and occur between 31 and 49% [1,2,3]
72 rats were randomly allocated to either our new composite mesh (monofilament PP mesh knitted with polylactic-acid-fibers (PLA)) or to a commercially available PP mesh that was used as a control. 15, 90, and 180 days after implantation into the rat abdomen mesh tissue complexes were analysed for erosion, contraction, foreign body reaction, tissue integration and biomechanical properties
Patrick Carteron is employed by Aspide Medical
Summary
Incisional ventral hernias are common side effects after abdominal surgery and occur between 31 and 49% [1,2,3]. The recurrence rates for ventral hernia repair with mesh surgery can be decreased to 10% [3] and halfened for POP repair [9]. Poly-propylene (PP) is probably the most widely used synthetic material [9] This non-degradable material preserves its integrity, and strengthens the fascia both by mechanical tension and by induction of an inflammatory reaction that causes excessive scar formation leading to local side effects, such as discomfort, pain and erosions in approximately 10% of all patients [5, 6, 11,12,13]
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