Comparing the host tissue response and peritoneal behavior of composite meshes used for ventral hernia repair

F García-Moreno, P Pérez-López, S Sotomayor… - journal of surgical …, 2015 - Elsevier
F García-Moreno, P Pérez-López, S Sotomayor, B Pérez-Köhler, Y Bayon, G Pascual…
journal of surgical research, 2015Elsevier
Background The use of a prosthetic material is the best treatment option for ventral hernia
repair; one of the most frequently performed abdominal surgery procedures. This preclinical
study compares the behavior of a new mesh (Parietex composite ventral patch [Ptx]) with
that of two existing meshes used for ventral hernia repair. Materials and methods Fifty-four
New Zealand White rabbits (3000 g) were used in an experimental model of umbilical hernia
repair (diameter 1.5 cm). The materials tested were: Ventralex ST hernia patch (Vent)(Bard …
Background
The use of a prosthetic material is the best treatment option for ventral hernia repair; one of the most frequently performed abdominal surgery procedures. This preclinical study compares the behavior of a new mesh (Parietex composite ventral patch [Ptx]) with that of two existing meshes used for ventral hernia repair.
Materials and methods
Fifty-four New Zealand White rabbits (3000 g) were used in an experimental model of umbilical hernia repair (diameter 1.5 cm). The materials tested were: Ventralex ST hernia patch (Vent) (Bard Davol Inc, Warwick, RI) (n = 18); Proceed ventral patch (Ethicon, Somerville, NJ) (PVP) (n = 18) and Ptx (Covidien, Sofradim, Trevoux, France) (n = 18). At 3, 7, 14 d, and 6 wk after implant, peritoneal behavior and adhesion formation were assessed by sequential laparoscopy. Mesh mesothelial cover was determined by scanning electron microscopy. Host tissue ingrowth (collagens I and III) and the macrophage response were assessed by immunohistochemical labeling. Animals were euthanized at 2, 6 wk, and 6 mo after surgery. Data were compared using the Mann–Whitney U test.
Results
Adhesion formation from 3 d–6 wk was significantly greater (P < 0.05) for PVP compared with Vent or Ptx. Three encapsulated PVP implants showed “tissue-integrated” adhesions affecting the intestinal loops. All three implant types showed similar patterns of collagen l and III deposition. The PVP mesh elicited the greater macrophage response both at 2 wk and 6 mo.
Conclusions
Ptx and Vent showed excellent mesothelialization, which led to minimum adhesion formation. The appropriate tissue integration of Ptx in the parietal neoperitoneum is likely attributable to its deployment system.
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