Morphological correlation of the functional mechanics of the abdominal wall after mesh implantation

Klosterhalfen, B.; Klinge, U.; Henze, U.; Bhardwaj, R.; Conze, Joachim; Schumpelick, W.

doi:10.1007/s004230050031

Cited by 17 publications

(17 citation statements)

References 7 publications

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“…Polypropylene (PPL) is probably the most widely used synthetic material [10,11]. This non-degradable material preserves its integrity and strengthens the fascia both by mechanical tension and by induction of an inflammatory reaction, which causes also excessive scar formation [12]. This inflammatory response may reflect poor tissue compatibility and may induce local side effects such as discomfort, pain and erosions [13].…”

Section: Introductionmentioning

confidence: 99%

Long-lasting bioresorbable poly(lactic acid) (PLA94) mesh: a new approach for soft tissue reinforcement based on an experimental pilot study

et al. 2007

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The purpose of this study was to evaluate host response and soft-tissue regeneration after poly(lactic acid) (PLA) mesh implantation in a rat model, in comparison with light-weight polypropylene (PPL) and poly(glycolic acid) (PGA) meshes. Full-thickness abdominal wall defects were created in 45 Wistar rats and reconstructed with 15 PLA(94), 15 PPL and 15 PGA meshes. Animals were killed on days 7, 30 and 90 to evaluate the presence of adhesions and changes in tensile strength of the implants. Histopathology and immunohistochemistry were performed to evaluate the collagen deposition and the inflammatory response. Statistics were done using unpaired Student's t-test, Mann-Whitney rank sum test, Student-Newman-Keuls test and Bonferroni (Dunn) t-test. The inflammatory response induced by the PLA mesh implantation was significantly milder than after PPL mesh. In PLA, vascularity and collagen organization was significantly higher than in PPL and PGA at 30 and 90 days, and collagen composition score was significantly higher than in PPL at 7 and 30 days. In PLA, shrinkage was significantly lower than in PPL and PGA at 7 and 30 days. Elongation at break and tensile strength were comparable between PLA and PPL over the 90-day period. The PLA mesh induces a milder inflammatory response, more orderly collagen deposition than PPL, and preserved comparable tensile strength after 90 days.

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Section: Introductionmentioning

confidence: 99%

Long-lasting bioresorbable poly(lactic acid) (PLA94) mesh: a new approach for soft tissue reinforcement based on an experimental pilot study

et al. 2007

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“…Polypropylene is probably the most widely used synthetic material [10,11]. This nonabsorbable material preserves its integrity and strengthens the fascia both by mechanical tension and by induction of a strong inflammatory reaction resulting in a strong scar formation [12]. On the other hand, a strong inflammatory response may reflect poor tissue compatibility, and may induce local side effects such as discomfort, pain, and erosions [13].…”

Section: Introductionmentioning

confidence: 99%

Collagen-coated vs noncoated low-weight polypropylene meshes in a sheep model for vaginal surgery. A pilot study

Tayrac

Alves²,

Thérin

2006

Int Urogynecol J

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The aims of this study were dual. First, to evaluate the feasibility of a sheep model as an animal model for vaginal surgery with meshes. Second, to compare host response to two low-weight polypropylene (PP) meshes, a noncoated (Soft Prolene, Gynecare, Ethicon) and a coated mesh with an absorbable hydrophilic film (Ugytex, Sofradim). Thirty-six 20 x 20 mm polypropylene meshes (18 coated and 18 noncoated) were surgically implanted by the vaginal route in 12 adult ewes. Meshes were implanted in the anterior (n=12) and the posterior vaginal compartments (n=24). Animals were killed 1 (n=6) and 12 (n=6) weeks after surgery. Postimplantation evaluation included macroscopical examination, histological and immunohistochemical analysis and histomorphometrical measures of the distance between the meshes and the vaginal epithelium. The experimental procedure was feasible in all cases. Vaginal erosions were observed twice as frequently with the noncoated-PP meshes (6/18, 33.3%) as with the coated-PP meshes (3/18, 16.7%), even if that difference was not significant (p=0.4). However, no differences were observed between the two meshes in terms of shrinkage, tissue ingrowth, inflammatory response, and position of the mesh in the vaginal wall. The mechanism involved in the reduction of vaginal erosion could be due to the lesser adhesion of the coated mesh on the vaginal wound during the early postoperative period.

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“…Poly-propylene (PPL) 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 also causes excessive scar formation [10] . This inflammatory response may reflect poor tissue compatibility, and may induce local side effects, such as discomfort, pain and erosions [11] .…”

Section: Introductionmentioning

confidence: 99%

Tissue Healing during Degradation of a Long-Lasting Bioresorbable γ-Ray-Sterilised Poly(Lactic Acid) Mesh in the Rat: A 12-Month Study

Tayrac

Letouzey²,

Guiraud³

et al. 2010

Eur Surg Res

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Aim: The purpose was to evaluate soft-tissue healing after poly(lactic acid) (PLA₉₄) mesh implantation in a rat model. Methods: Full-thickness abdominal wall defects were created in 108 Wistar rats, and reconstructed with 83 PLA₉₄ and 25 lightweight polypropylene (PPL) meshes. The meshes were previously γ-ray sterilised with 25, 75 or 125 kGy to accelerate PLA₉₄ degradation. Results: The inflammatory response in PLA₉₄ was significantly less pronounced and collagen organisation significantly better than in PPL. The higher the level of γ-radiation, the higher the incidence of abdominal wall herniation (22.2, 31.3 and 52.6% with 25, 75 and 125 kGy, respectively). No herniation occurred in the PPL group. Tensile strength was dramatically reduced after γ-ray-sterilised PLA₉₄ mesh implantation. Conclusion: The γ-ray-sterilised PLA₉₄ mesh was poor in preventing abdominal wall hernia recurrences in a rat model.

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Morphological correlation of the functional mechanics of the abdominal wall after mesh implantation

Cited by 17 publications

References 7 publications

Long-lasting bioresorbable poly(lactic acid) (PLA94) mesh: a new approach for soft tissue reinforcement based on an experimental pilot study

Long-lasting bioresorbable poly(lactic acid) (PLA94) mesh: a new approach for soft tissue reinforcement based on an experimental pilot study

Collagen-coated vs noncoated low-weight polypropylene meshes in a sheep model for vaginal surgery. A pilot study

Tissue Healing during Degradation of a Long-Lasting Bioresorbable γ-Ray-Sterilised Poly(Lactic Acid) Mesh in the Rat: A 12-Month Study

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