Morphologische Korrelation der funktionellen Bauchwandmechanik nach Mesh-Implantation

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

doi:10.1007/pl00008025

Cited by 6 publications

(8 citation statements)

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“…Synthetic materials such as polypropylene induce an intensive inflammatory response, 8,9 which may be responsible for poor tissue compatibility, and lead to adhesion formation, infection and other complications, 10 such as dyspareunia, pain, bladder dysfunction, stone formation and infection, bowel obstruction and abdominal pain. 11 There are newer implant materials derived from biological sources available, one of which is porcine small intestine submucosa (SIS)-derived, non-cross-linked collagen matrix, marketed as SIS (Cook, Strombeek-Bever, Belgium).…”

Section: Introductionmentioning

confidence: 99%

Comparison of host response to polypropylene and non‐cross‐linked porcine small intestine serosal‐derived collagen implants in a rat model

Konstantinovic

Lagae

Zheng

et al. 2005

BJOG

106

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Objective To compare the host response, architectural integration and tensile strength of polypropylene and porcine small intestine submucosa-derived implants in a rat model. Design Experimental study.Setting Center for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium.Sample Forty-eight adult male Wistar rats weighing 220-250 g randomised to receive either implant.Methods Full thickness abdominal wall defects were primarily repaired with polypropylene mesh (Marlex) (MX group) or porcine small intestine submucosa (Surgisis) (SIS group). Animals were sacrificed at 7, 14, 30 and 90 days after implantation. Main outcome measures The presence of herniation, infection and intra-peritoneal adhesions. Change in thickness and tensile strength of implant. Histopathological and immunohistochemical appearances of inflammatory response and collagen deposition. Results Implants from the SIS group showed a short term increase in thickness in the first 14 days. Formation of adhesions was significantly more intense in the MX group at 30 days, and more extensive in the SIS group at 90 days. Tensile strength increased over time in both groups but was significantly lower in the SIS group than the MX group at 30 days. Implants in the MX group showed a more pronounced inflammatory response and more pronounced new vessel formation than the SIS group. Collagen formation was initially more fibrous and better organised in the MX group but became greater in the SIS group at 90 days. Conclusions Biologically derived implant material induced a less pronounced inflammatory response and differences in collagen deposition. At 30 days tensile strength was weaker in the biological implant group but was equivalent by 90 days. These differences may have implications for the in vivo performance of the materials.

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Section: Introductionmentioning

confidence: 99%

Comparison of host response to polypropylene and non‐cross‐linked porcine small intestine serosal‐derived collagen implants in a rat model

Konstantinovic

Lagae

Zheng

et al. 2005

BJOG

106

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“…These consequences of the biological response to the foreign material are markedly influenced by the amount of incorporated material, particularly depending on the surface and the pore size. 5,6 Theoretical considerations, as well as the intraoperatively measured tensile strength during hernia repair, indicate that most of the currently available mesh materials are oversized with inappropriate elastic properties. 7 Both animal experiments and clinical experience have shown that adapting the mesh to the physiological demands by reducing the amount of introduced material (amount of polypropylene Ͻ 30 g/m 2 ) and enlarging the pore size (as in a multifilament low-weight mesh) results in a significant improvement in biocompatibility.…”

Section: Introductionmentioning

confidence: 99%

Functional and morphological evaluation of a low‐weight, monofilament polypropylene mesh for hernia repair

Klinge

Junge

Stumpf

et al. 2002

J. Biomed. Mater. Res.

Self Cite

113

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With more than 1 million implantations per year worldwide, mesh repair has become a standard procedure for the treatment of hernias. Apart from various technical problems, the type of material has been proven to be of considerable importance for the functional and histological outcome, particularly for long-term implantation. Whereas the advantageous application of low-weight, large-pore meshes based on multifilaments can be stated without doubt, it is still open whether similar results can be achieved on the basis of pure monofilaments. In the present study, a low-weight polypropylene mesh (LW) made purely of monofilaments was compared to a common heavy-weight polypropylene mesh (HW) in regard to the functional consequences and the tissue response. After implantation in rats as an inlay for 3--90 days, the abdominal-wall mobility of the implant region was recorded by 3D stereography, and the tensile strength of both the suture zone and the mesh was measured. The morphometry of the histological reaction in regard to the inflammatory infiltrate, the connective tissue, the number of granulocytes, macrophages, and fibroblasts served to reflect the tissue response. As parameters for the remodeling process at the interface the cellular activation was evaluated by TUNEL (DNA-strand breaks or apoptosis, respectively), Ki 67 (cell proliferation), and HSP 70 (cell stress). The measured tensile strength of the LW mesh confirmed a sufficient strength of the material-reduced mesh modification. After implantation the consecutive impairment of the abdominal-wall mobility was reduced compared to the HW mesh, concomitant to the reduced fibrotic level at the interface. At the end of the observation period the foreign-body reaction was significantly lowered for the LW mesh, almost reaching physiological values. In conclusion, these data confirm the improved biocompatibility of material-reduced mesh implants.

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“…Meshes, finden in zunehmendem Maß Anwendung bei der Versorgung von Hernien, insbesondere von Narbenhernien. Ihre primäre Aufgabe ist dabei die Verstärkung und Stabilisierung der Bauchwand, was durch den mechanischen Verschluss der Bruchlücke und die Induktion einer Narbenplatte mit dem Netz als zentralem Element erreicht wird [7,8,18]. Ihr Einsatz führte zu einer deutlichen Reduktion der Rezidivrate bei mit Meshes versorgten Narbenhernien bzw.…”

Section: Schlüsselwörterunclassified

“…Wäh-rend dazu zahlreiche Untersuchungen über die entzündlichen Fremdkörperreaktionen im Gewebe nach Implantation von Kunststoffen existieren [6,7,8,10,19], fehlen weitergehende Untersuchungen über die zellulären Reaktionen insbesondere auf molekularer Ebene. Deshalb mehren sich in letzter Zeit auch kritische Stimmen, die vor einem unkontrollierten Einsatz dieser Meshes warnen, da zu wenig über die Spätfolgen und eine mögliche Entartungstendenz bekannt ist [16], zumal tierexperimentell die Sarkominduktion durch alloplastisches Material eindeutig gesichert werden konnte [4,13,14].…”

Section: Schlüsselwörterunclassified

Kunststoffnetze aus Polypropylen beeinflussen das Wachstum humaner Zellen in vitro Eine experimentelle Studie

Duchrow¹,

Windhövel²,

Bethge³

et al. 2002

Chirurg

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Morphologische Korrelation der funktionellen Bauchwandmechanik nach Mesh-Implantation

Cited by 6 publications

References 0 publications

Comparison of host response to polypropylene and non‐cross‐linked porcine small intestine serosal‐derived collagen implants in a rat model

Comparison of host response to polypropylene and non‐cross‐linked porcine small intestine serosal‐derived collagen implants in a rat model

Functional and morphological evaluation of a low‐weight, monofilament polypropylene mesh for hernia repair

Kunststoffnetze aus Polypropylen beeinflussen das Wachstum humaner Zellen in vitro Eine experimentelle Studie

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