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The long-term behavior of lightweight and heavyweight meshes used to repair abdominal wall defects is determined by the host tissue repair process provoked by the mesh.
- Source :
-
Surgery [Surgery] 2012 Nov; Vol. 152 (5), pp. 886-95. Date of Electronic Publication: 2012 May 08. - Publication Year :
- 2012
-
Abstract
- Background: Although heavyweight (HW) or lightweight (LW) polypropylene (PP) meshes are widely used for hernia repair, other alternatives have recently appeared. They have the same large-pore structure yet are composed of polytetrafluoroethylene (PTFE). This study compares the long-term (3 and 6 months) behavior of meshes of different pore size (HW compared with LW) and composition (PP compared with PTFE).<br />Methods: Partial defects were created in the lateral wall of the abdomen in New Zealand White rabbits and then repaired by the use of a HW or LW PP mesh or a new monofilament, large-pore PTFE mesh (Infinit). At 90 and 180 days after implantation, tissue incorporation, gene and protein expression of neocollagens (reverse transcription-polymerase chain reaction/immunofluorescence), macrophage response (immunohistochemistry), and biomechanical strength were determined. Shrinkage was measured at 90 days.<br />Results: All three meshes induced good host tissue ingrowth, yet the macrophage response was significantly greater in the PTFE implants (P < .05). Collagen 1/3 mRNA levels failed to vary at 90 days yet in the longer term, the LW meshes showed the reduced genetic expression of both collagens (P < .05) accompanied by increased neocollagen deposition, indicating more efficient mRNA translation. After 90-180 days of implant, tensile strengths and elastic modulus values were similar for all 3 implants (P > .05).<br />Conclusion: Host collagen deposition is mesh pore size dependent whereas the macrophage response induced is composition dependent with a greater response shown by PTFE. In the long term, macroporous meshes show comparable biomechanical behavior regardless of their pore size or composition.<br /> (Copyright © 2012 Mosby, Inc. All rights reserved.)
- Subjects :
- Animals
Biomechanical Phenomena
Fluorescent Antibody Technique
Gene Expression
Herniorrhaphy
Macrophages physiology
Male
Microscopy
Rabbits
Real-Time Polymerase Chain Reaction
Reverse Transcriptase Polymerase Chain Reaction
Wound Healing immunology
Abdominal Wall surgery
Collagen metabolism
Polypropylenes
Polytetrafluoroethylene
Surgical Mesh
Subjects
Details
- Language :
- English
- ISSN :
- 1532-7361
- Volume :
- 152
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 22575883
- Full Text :
- https://doi.org/10.1016/j.surg.2012.03.009