Background: The open abdomen with mesh implantation, followed by early reoperation with fascial closure, is a modern surgical approach in difficult clinical situations such as severe abdominal
sepsis. As early fascial closure is not possible in many cases, mesh-mediated fascial
traction is helpful for conditioning of a minimized
ventral hernia after open abdomen. The aim of this study was to evaluate the clinical utilization of an innovative elastic thermoplastic
polyurethane mesh (TPU) as an abdominal wall
inlay in a minipig model. Methods: Ten minipigs were divided in two groups, either receiving an elastic TPU mesh or a nonelastic
polyvinylidene fluoride (
PVDF) mesh in
inlay position of the abdominal wall. After 8 weeks, mesh expansion and abdominal wall defect size were measured. Finally, pigs were euthanized and abdominal walls were explanted for histological and immunohistochemical assessment. Results: Eight weeks after abdominal wall replacement, transversal diameter of the fascial defect in the TPU group was significantly smaller than in the
PVDF group (4.5 cm vs. 7.4 cm; p = 0.047). Immunhistochemical analysis showed increased Ki67 positive cells (p = 0.003) and a higher number of apoptotic cells (p = 0.047) after abdominal wall replacement with a TPU mesh.
Collagen type I/III ratio was increased in the
PVDF group (p = 0.011). Conclusion: Implantation of an elastic TPU mesh as abdominal wall
inlay is a promising approach to reduce the size of the
ventral hernia after open abdomen by mesh-mediated
traction. However, this effect was associated with a slightly increased
foreign body reaction in comparison to the nonelastic
PVDF.