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Mesh implants in hernia repair. Inflammatory cell response in a rat model
R Rosch1, K Junge, A Schachtrupp
1Department of Surgery, RWTH-Aachen University, Aachen, Germany. r.rosch@chir.rwth-aachen.de
Summary
Surgical mesh biocompatibility was assessed by examining inflammatory cell infiltration and proliferation. Polypropylene/polyglactin meshes showed reduced macrophage colonization, suggesting improved biocompatibility compared to polypropylene and polyethylene terephthalate meshes.
Area of Science:
- Biomaterials Science
- Immunology
- Surgical Innovation
Background:
- Abdominal wall reinforcement with mesh implants can lead to complications like hernia recurrence and infection.
- The biocompatibility of alloplastic prostheses is crucial for minimizing adverse events.
- Macrophages, T-cells, and mast cells significantly influence the inflammatory response to biomaterials.
Purpose of the Study:
- To evaluate the biocompatibility of different clinically used surgical meshes.
- To investigate the cellular infiltrate and proliferation rates in response to various mesh materials.
Main Methods:
- Three mesh types (polypropylene, polyethylene terephthalate, polypropylene/polyglactin) were implanted in a rodent model.
- Histochemical analysis was performed at 7 and 90 days post-implantation.
- Macrophages, T-cells, proliferating cells, and mast cells were quantified.
Main Results:
- A persistent T-cell response was observed across all mesh groups.
- Polypropylene/polyglactin meshes exhibited reduced macrophage colonization compared to other groups.
- Mast cell infiltration decreased over time in polyethylene terephthalate and polypropylene/polyglactin groups, but increased in the polypropylene group.
- Proliferation indices were highest in the polypropylene mesh group.
Conclusions:
- A biomaterial-dependent chronic inflammatory response to surgical meshes occurs, with macrophages being the predominant cell type.
- The findings suggest differential biocompatibility among the tested surgical meshes.
- Further research into inflammatory cell recruitment, particularly mast cells, is warranted.