Comparing the host tissue response and peritoneal behavior of composite meshes used for ventral hernia repair.

Abstract

BACKGROUND:

The use of a prosthetic material is the best treatment option for ventral hernia repair; one of the most frequently performed abdominal surgery procedures. This preclinical study compares the behavior of a new mesh (Parietex composite ventral patch [Ptx]) with that of two existing meshes used for ventral hernia repair.

MATERIALS AND METHODS:

Fifty-four New Zealand White rabbits (3000 g) were used in an experimental model of umbilical hernia repair (diameter 1.5 cm). The materials tested were: Ventralex ST hernia patch (Vent) (Bard Davol Inc, Warwick, RI) (n = 18); Proceed ventral patch (Ethicon, Somerville, NJ) (PVP) (n = 18) and Ptx (Covidien, Sofradim, Trevoux, France) (n = 18). At 3, 7, 14 d, and 6 wk after implant, peritoneal behavior and adhesion formation were assessed by sequential laparoscopy. Mesh mesothelial cover was determined by scanning electron microscopy. Host tissue ingrowth (collagens I and III) and the macrophage response were assessed by immunohistochemical labeling. Animals were euthanized at 2, 6 wk, and 6 mo after surgery. Data were compared using the Mann-Whitney U test.

RESULTS:

Adhesion formation from 3 d-6 wk was significantly greater (P < 0.05) for PVP compared with Vent or Ptx. Three encapsulated PVP implants showed "tissue-integrated" adhesions affecting the intestinal loops. All three implant types showed similar patterns of collagen l and III deposition. The PVP mesh elicited the greater macrophage response both at 2 wk and 6 mo.

CONCLUSIONS:

Ptx and Vent showed excellent mesothelialization, which led to minimum adhesion formation. The appropriate tissue integration of Ptx in the parietal neoperitoneum is likely attributable to its deployment system.

• Authors: Francisca García-Moreno, Paloma Pérez-López, Sandra Sotomayor, Bárbara Pérez-Köhler, Yves Bayon, Gemma Pascual, Juan M Bellón
• Journal: The Journal of surgical research (J Surg Res) Vol. 193 Issue 1 Pg. 470-82 (Jan 2015) ISSN: 1095-8673 [Electronic] United States
• PMID: 25150083 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Polyesters
• Polypropylenes
• parietex
• Collagen

Topics

• Abdominal Wall (pathology, surgery)
• Animals
• Collagen (pharmacology)
• Hernia, Umbilical (pathology, surgery)
• Herniorrhaphy (instrumentation, methods)
• Male
• Materials Testing
• Microscopy, Electron, Scanning
• Models, Animal
• Peritoneum (pathology, surgery, ultrastructure)
• Polyesters (pharmacology)
• Polypropylenes (pharmacology)
• Prostheses and Implants
• Rabbits
• Surgical Mesh
• Tissue Adhesions (pathology, prevention & control)
• Wound Healing