Adhesion formation of a polyvinylidenfluoride/polypropylene mesh for intra-abdominal placement in a rodent animal model |
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Authors: | Karsten Junge Marcel Binnebösel Raphael Rosch Marc Jansen Daniel Kämmer Jens Otto Volker Schumpelick Uwe Klinge |
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Institution: | Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany. karsten.junge@post.rwth-aachen.de |
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Abstract: | Background Effective laparoscopic ventral herniorrhaphy mandates the use of an intraperitoneal mesh. Visceral adhesions and shrinkage
of prosthetics may complicate repairs. The aim of this study was to compare adhesion formation, mesh shrinkage and tissue
ingrowth after intra-abdominal placement of a novel two-component monofilament mesh structure made of polypropylene (PP) and
polyvinylidenfluoride (PVDF) with current alternatives.
Materials and methods Forty Sprague-Dawley rats were used in this study. Mesh samples were fixed as intra-abdominal only mesh at the right lateral
abdominal wall. The study groups were: PVDF+PP (polypropylene parietally and polyvinylidenfluoride viscerally), PP+Col (polypropylene
with a collagenoxidized film), ePTFE (smooth surface viscerally and a textured surface parietally), and PP (a pure polypropylene
mesh serving as control). The meshes were explanted after 30 days. Adhesions were scored as a percentage of explanted biomaterials’
affected surface area; prosthetic shrinkage was calculated. Foreign-body reaction to mesh materials was measured by investigating
the amount of inflammatory infiltrate and fibrotic tissue formation.
Results In terms of adhesion score, the pure PP mesh showed the highest values followed by the ePTFE, PVDF+PP, and PP+Col meshes.
Quantitative assessment of adhesion area revealed a significantly higher value of the pure PP mesh sample (62.0 ± 22.1%) compared
with the PP+Col (26.8 ± 12.1%) and the PVDF+PP mesh (34.6 ± 8.2%). Percentage of shrinkage showed a significantly higher value
of the ePTFE mesh (52.4 ± 13.9%) compared with all other mesh modifications (PP+Col 19.8 ± 13.9%, PVDF+PP 19.9 ± 7.0%, and
PP 26.8 ± 9.5%). Inflammatory infiltrate was significantly reduced in the PVDF+PP mesh group compared with all other mesh
samples.
Conclusion The use of the novel two-component monofilament mesh structure made of polypropylene and polyvinylidenfluoride was found to
be favorable regarding adhesion formation and mesh shrinkage compared to conventional mesh materials used for intra-abdominal
placement. |
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Keywords: | Mesh Adhesion Shrinkage IPOM |
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