The early outcomes of complex abdominal wall reconstruction with polyvinylidene (PVDF) mesh in the setting of active infection: a prospective series

Birolini, Cláudio; Tanaka, Eduardo; Miranda, Jocielle Santos de; Murakami, Abel H.; Damous, Sérgio Henrique Bastos; Utiyama, Edivaldo Massazo

doi:10.1007/s00423-022-02625-2

Cited by 4 publications

(2 citation statements)

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“…These results demonstrate the superiority of PVDF meshes in comparison to PP meshes in terms of their subsequent susceptibility to infection [11]. This reduced associated risk of infection is consistent with the fact that PVDF meshes have been applied in abdominal wall reconstruction in a prospective cohort of patients with chronic infections and enteric fistulas [12].…”

Section: Discussionsupporting

confidence: 73%

“…Also, PVDF meshes appear to be linked to a lower inflammatory tissue response than PP meshes [1,11]. PVDF meshes have even been used for abdominal wall reconstruction in cases of enteric fistulas in a setting of massive bacterial exposure with favorable results [12]. Engelsman et al showed an increased risk for mesh infection with a larger mesh surface, either due to the size of the material used or the filamentous structure [9].…”

Section: Introductionmentioning

confidence: 99%

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Choice of Polymer, but Not Mesh Structure Variation, Reduces the Risk of Bacterial Infection with Staphylococcus aureus In Vivo

et al. 2023

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Background: Synthetic mesh material is of great importance for surgical incisional hernia repair. The physical and biochemical characteristics of the mesh influence mechanical stability and the foreign body tissue reaction. The influence on bacterial infections, however, remains ill-defined. The aim of the present study was to evaluate the influence of a modified mesh structure with variation in filament linking on the occurrence of bacterial infection that is indicated by the occurrence of CD68+, CD4+, and CD8+ cells in two different materials. Methods: A total of 56 male Sprague Dawley rats received a surgical mesh implant in a subcutaneous abdominal position. The mesh of two different polymers (polypropylene (PP) and polyvinylidenfluoride (PVDF)) and two different structures (standard structure and bold structure with higher filament linking) were compared. During the implantation, the meshes were infected with Staphylococcus (S.) aureus. After 7 and 21 days, meshes were explanted, and the early and late tissue responses to infection were histologically evaluated. Results: Overall, the inflammatory tissue response was higher at 7 days when compared to 21 days. At 7 days, PP meshes of the standard structure (PP-S) showed the strongest inflammatory tissue response in comparison to all the other groups. At 21 days, no statistically significant difference between different meshes was detected. CD8+ cytotoxic T cells showed a significant difference at 21 days but not at 7 days. PP meshes of both structures showed a higher infiltration of CD8+ T cells than PVDF meshes. CD4+ T helper cells differed at 7 days but not at 21 days, and PVDF meshes in a bold structure showed the highest CD4+ T cell count. The number of CD68+ macrophages was also significantly higher in PP meshes in a standard structure when compared to PVDF meshes at 21 days. Conclusion: The inflammatory tissue response to S. aureus infection appears to be highest during the early period after mesh implantation. PP meshes showed a higher inflammatory response than PVDF meshes. The mesh material appears to be more important for the risk of infection than the variation in filament linking.

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Section: Discussionsupporting

confidence: 73%