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Introduction: Despite the advantages offered by meshes, their use in abdominal wall repair can promote adhesions and damage the intra-abdominal viscera. This study was designed to assess the behavior at the peritoneal interface of several composite prostheses using sequential laparoscopy to monitor the real-time adhesion formation process., Materials and Methods: Three composite prostheses, Parietex Composite (n=8), Sepramesh (n=8) and PL-PU 99 (n=8), were used to repair 7 x 5 cm defects created in the abdominal wall of 24 New Zealand white rabbits. The area occupied by adhesions at 3, 7 and 14 days after prosthesis placement was established by tracing the adhesions onto a polyethylene template, using images obtained from sequential laparoscopy, and subjecting it to image analysis. At 14 days, the animals were sacrificed and specimens of the prostheses plus adjacent host tissue were obtained for histological and morphometric tests., Results: Adhesion formation was laparoscopically observed to stabilize between 7 and 14 days post-implant, with no increase in adhesions produced at 14 days. The Parietex and PL-PU99 meshes showed significantly lower proportions of adhesions (0.55 +/- 0.06% and 0.27 +/- 0.20% respectively) than Sepramesh (18.55 +/- 1.96%). All three composites induced similar host tissue ingrowth and mesothelialization of the peritoneal prosthetic surface., Conclusions: a) The three prostheses tested showed optimal behavior at the peritoneal interface; b) the critical period when most adhesions form is the first week after implant; c) these biomaterials are suitable for use in laparoscopic ventral hernia repair.

Background: When repairing an abdominal wall defect, sometimes a prosthetic mesh needs to be placed directly on the parietal peritoneum. Although the standard mesh for this purpose is the laminar implant expanded polytetrafluoroethylene (PTFE), it is gradually being replaced by the laminar collagen-based meshes. This study was designed to assess the intraperitoneal behavior of three of these biomeshes, mainly in terms of their susceptibility to adhesion formation. Methods: Two 3-cm × 3-cm fragments of prosthetic material were placed on the parietal peritoneum in male New Zealand White rabbits in the following combinations: PTFE and CollaMend, PTFE and Permacol, or PTFE and Surgisis. The meshes were fixed at the four corners with individual 4/0 polypropylene sutures. Adhesion formation was quantified by sequential laparoscopy and image analysis performed at 3, 7, 14, and 90 days postimplant. All animals were killed at 90 days and the mesh specimens were subjected to microscopy and immunohistochemistry. Results: Intensely vascularized adhesions to all the implants were observed, although Surgisis showed the lowest percentage of adhesions at each follow-up time. Adhesions had stabilized by 7-14 days. The PTFE meshes were enveloped by a layer of macrophages and connective tissue, bounded by a monolayer of mesothelial cells. Permacol and CollaMend showed similar histological behavior, including cell ingrowth through their fenestrations with no signs of degradation detected at 90 days. In contrast, the Surgisis mesh at 90 days was practically replaced with neoformed tissue. Conclusions: No difference in susceptibility to adhesion formation was noted in the crosslinked collagen meshes compared to PTFE meshes. The noncrosslinked collagen mesh Surgisis showed the best behavior in that it induced fewer adhesions. Ninety days after implant, a more intense macrophage response was observed in CollaMend and Permacol than in PTFE or Surgisis. [ABSTRACT FROM AUTHOR]

Background. Over the years, reticular prostheses have undergone changes in their structure and composition to give rise to today's partially absorbable lightweight meshes. This study was designed to assess the biological and biomechanical behavior of these prostheses to establish whether they offer any advantages over nonabsorbable lightweight polypropylene prostheses. Materials and Methods. 7 × 5 cm defects were created in the anterior abdominal wall of New Zealand White rabbits and repaired by securing different prostheses to the edges of the defect with a running 4/0 polypropylene suture. The lightweight biomaterials compared were two nonabsorbable meshes: Parietene® and Optilene elastic® , and two partially absorbable prostheses: Vypro II® and Ultrapro®. At 14 and 90 days postimplant, tissue/prosthesis specimens were subjected to histological, immunohistochemical, shrinkage, and biomechanical analyses. Results. Adhesion formation on the peritoneum-facing surface of the meshes was significantly less extensive in the meshes with absorbable components at 90 days postimplant. The newly formed tissue around the prosthetic filaments was comprised of collagen fibers, fibroblasts, blood vessels, and macrophages. The partially absorbable meshes showed higher macrophage proportions (due to remnants of absorbable material and their structure) than the nonabsorbable meshes at 90 days, although differences were not significant. At 90 days postimplant, similar tensile strengths were recorded for all the implants. Conclusions. All the prosthetic materials induced good host tissue ingrowth, with no significant differences in tensile strength observed. Our findings suggest that partially absorbable lightweight prostheses could offer advantages over nonabsorbable lightweight meshes since less foreign material persists in the recipient, improving abdominal wall compliance. [ABSTRACT FROM AUTHOR]

Biomaterials have long been used to repair defects in the clinical setting, which has led to the development of a wide variety of new materials tailored to specific therapeutic purposes. The efficiency in the repair of the defect and the safety of the different materials employed are determined not only by the nature and structure of their components, but also by the anatomical site where they will be located. Biomaterial implantation into the abdominal cavity in the form of a surgical mesh, such as in the case of abdominal hernia repair, involves the contact between the foreign material and the peritoneum. This review summarizes the different biomaterials currently available in hernia mesh repair and provides insights into a series of peculiarities that must be addressed when designing the optimal mesh to be used in this interface. [ABSTRACT FROM AUTHOR]