Vypro II^® Mesh in Hernia Repair: Impact of Polyglactin on Long-Term Incorporation in Rats

Abstract

Background: To the Vypro II^® mesh, a large-pore-sized multifilamentous polypropylene mesh for hernia repair, supplementary polyglactin 910 multifilaments were added to improve intraoperative handling. As it has been suggested that polyglactin induces fibroplastic reactions and wound complications, this study was designed to evaluate the long-term tissue reaction to polyglactin in the Vypro II mesh. Materials and Methods: Two mesh materials, the Vypro II composite mesh (PP + PG) and the pure polypropylene variant (PP), were compared after inlay implantation in a standardized rodent animal model. After 14, 28, 42, 56, 84 and 112 days of implantation, histological analysis of the inflammatory response was performed: material absorption, inflammatory tissue reaction, fibrosis and granuloma formation were investigated. Results: Total absorption of polyglactin filaments of the Vypro II mesh occurred between 56 and 84 days of implantation. Both the inflammatory and the fibrotic reaction were initially increased in the PP + PG mesh group. These differences disappeared in the following implantation period. After 112 days, inflammation was even less pronounced in the PP + PG mesh group. Conclusion: The present data confirm a short-term polyglactin-induced increase in inflammation and fibrosis around implanted Vypro II meshes in rats. With regard to the long-term tissue response, even an anti-inflammatory property of polyglactin multifilaments in low-weight and large-pored polypropylene meshes cannot be ruled out.

Influence of hernioplastic implants on male fertility in rats

“…However, in both cases the mucosa was not involved. This result is in contrast to Rosch et al, 23 who observed differences in the inflammatory reactions to this two mesh types. In another investigation, no differences were reported between this two meshes with regard to inflammatory reactions.…”

Comet-Tail-Like Inflammatory Infiltrate to Polymer Filaments Develops in Tension-Free Conditions

“…In contact with the suture surface, inflammatory cells transform to foreign body giant cells. The entire inflammatory infiltrate (inner granuloma) is sealed by a collagen-rich fibrotic capsule (outer granuloma) [3,4]. Impaired biocompatibility leads to extended foreign body response.…”

Hernias epigástricas recidivantes. ¿Manejo ideal o sugerido?

“…Respecto a la formación de fibrosis por la colocación de material protésico, en otro estudio en ratas sobre la reparación de hernias con malla Vypro II®, se comprobó que inicialmente aumentaba la reacción fibrótica e inflamatoria; sin embargo, hacia el día 112 después de la implantación completa de la malla, la fibrosis desaparecía y era menos evidente que, incluso, en los experimentos de control ( 14).…”