Angiogenic and inflammatory host response to surgical meshes of different mesh architecture and polymer composition

One of the major challenges in hernia repair is the development of surgical meshes that guarantee an optimal biocompatibility and incorporation into the host tissue. For this purpose, it is necessary to study the impact of different mesh types on angiogenesis, inflammation, and tissue formation. In the present study, we analyzed the host tissue reaction to Prolene, Ultrapro, and Vicryl meshes over a 14-day period after implantation into the hamster dorsal skinfold chamber using intravital fluorescence microscopy and histology. Our results demonstrate that compared with the Prolene and Ultrapro mesh, the Vicryl mesh induced a more pronounced angiogenic and inflammatory host tissue response with formation of a densely vascularized granulation tissue, which was infiltrated by many inflammatory cells. However, the strong foreign body reaction was not associated with a better mesh incorporation, but resulted in a significantly reduced explantation strength when compared with that of Prolene and Ultrapro meshes. Histological examinations revealed that the granulation tissue surrounding the Vicryl mesh was instable, because of low collagen content and massive infiltration of inflammatory cells. Thus, our data demonstrate that a stronger angiogenic and inflammatory response to an implanted mesh does not necessarily result in a better incorporation into the host tissue.