Tissue reaction to polypropylene and polyester in obese patients

Area of Science:

• Biomaterials Science
• Surgical Innovation
• Obesity Research

Background:

• Gastrointestinal surgery, particularly bariatric procedures for obesity, often requires prosthetic materials for reinforcement.
• Understanding the local tissue response to implanted biomaterials is crucial for patient safety and surgical outcomes.
• Marlex (polypropylene) and Dacron (polyester) are commonly used synthetic polymers in surgical applications.

Purpose of the Study:

• To compare the local tissue reaction to Marlex and Dacron following subcutaneous implantation in extremely obese patients.
• To evaluate the tissue response in the omentum covering surgical reinforcement bands during reoperations.
• To assess the suitability of Marlex versus Dacron as reinforcement materials in gastric surgery for obesity.

Main Methods:

• Subcutaneous implantation of Marlex and Dacron samples in 11 extremely obese patients for 8 weeks.
• Histopathological examination of tissue reactions, including chronic inflammation and foreign body giant cell response.
• Analysis of tissue reactions in the omentum of 9 patients undergoing reoperation for gastric banding complications.

Main Results:

• Dacron elicited a stronger chronic inflammatory reaction in 7 of 11 patients and a more pronounced foreign body giant cell reaction in all patients compared to Marlex.
• No significant difference in tissue reaction was observed between subcutaneous fat and omental tissue covering the implanted bands.
• None of the reoperations were attributed to excessive tissue reactions to Marlex (used in 8 patients) or Gore-tex (Teflon) (used in 1 patient).

Conclusions:

• Marlex appears to be more suitable than Dacron for use as a reinforcement band in gastric surgery for obesity due to a less intense local tissue response.
• The tissue reaction to implanted biomaterials in the omentum is comparable to that in subcutaneous tissue.
• The studied biomaterials, including Marlex and Gore-tex, demonstrate a favorable safety profile regarding tissue reaction in the context of gastric banding complications.