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Surg Endosc. 2015 Aug;29(8):2251-9. doi: 10.1007/s00464-014-3936-5. Epub 2014 Nov 1.

Long-term evaluation of adhesion formation and foreign body response to three new meshes.

Author information

1
Department of Surgery, Research Institute NUTRIM, Maastricht University Medical Centre, Maastricht, The Netherlands, r.vogels@maastrichtuniversity.nl.

Abstract

INTRODUCTION:

Mesh-related adhesions are a significant clinical problem following intraperitoneal mesh placement. In this study, we evaluated adhesion formation to three relatively new meshes for intraperitoneal use.

METHODS:

Three new meshes for intraperitoneal use (Omyra(®) mesh, Physiomesh(®), and Hi-Tex Endo-IP(®)) were implanted intraperitoneally in rats and compared with a polypropylene control mesh (Parietene(®)) after 7 or 90 days. Adhesion formation, incorporation (tensile strength), shrinkage, and foreign body reaction were scored.

RESULTS:

Hi-Tex Endo-IP and Physiomesh(®) showed significantly less adhesion formation when compared to Parietene at both time points (p < 0.05). Shrinkage was highest in Omyra mesh after 90 days, which was significantly more compared to Parietene(®) (p < 0.001). Physiomesh(®) only showed a significant reduction in craniocaudal mesh length, compared to Parietene and Hi-Tex Endo-IP (p < 0.05). After 90 days, Hi-Tex Endo-IP(®) showed significantly higher and Physiomesh(®) significantly lower incorporation strengths compared to all other groups (p < 0.05). Microscopic evaluation revealed massive foreign body reaction to Hi-Tex Endo-IP(®), leading to an extensive and thick collagenous scar adherent to the abdominal wall. Fractioning of the Physiomesh(®) coating over time led to an increase in interfilamentary granuloma formation, leading to scar plate formation, but with only minimal to no abdominal wall adherence. Both Parietene(®) and Omyra(®) showed a mild foreign body response.

CONCLUSION:

Although clear distinctions can be made between meshes and some meshes excel, none of the meshes are superior in all aspects required for effective and safe incisional hernia repair.

PMID:
25361655
DOI:
10.1007/s00464-014-3936-5
[Indexed for MEDLINE]

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