Presented to the Fifth Congress of the American Hernia Society, New York, USA, March 2012, and the Annual Meeting of the Dutch Society of Surgery, Veldhoven, The Netherlands, May 2012; published in abstract form as Hernia 2012; 16(Suppl 1): p S59
Experimental study on synthetic and biological mesh implantation in a contaminated environment†
Article first published online: 6 NOV 2012
Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 99, Issue 12, pages 1734–1741, December 2012
How to Cite
Deerenberg, E. B., Mulder, I. M., Grotenhuis, N., Ditzel, M., Jeekel, J. and Lange, J. F. (2012), Experimental study on synthetic and biological mesh implantation in a contaminated environment. Br J Surg, 99: 1734–1741. doi: 10.1002/bjs.8954
- Issue published online: 6 NOV 2012
- Article first published online: 6 NOV 2012
- Manuscript Accepted: 16 JUL 2012
Implantation of meshes in a contaminated environment can be complicated by mesh infection and adhesion formation.
The caecal ligation and puncture model was used to induce peritonitis in 144 rats. Seven commercially available meshes were implanted intraperitoneally: six non-absorbable meshes, of which three had an absorbable coating, and one biological mesh. Mesh infection, intra-abdominal abscess formation, adhesion formation, incorporation and shrinkage were evaluated after 28 and 90 days. Histological examination with haematoxylin and eosin and picrosirius red staining was performed.
No mesh infections occurred in Sepramesh®, Omyramesh® and Strattice®. One mesh infection occurred in Parietene® and Parietene Composite®. Significantly more mesh infections were found in C-Qur® (15 of 16; P ≤ 0·006) and Dualmesh® (7 of 15; P ≤ 0·035). Sepramesh® showed a significant increase in adhesion coverage from 12·5 per cent at 28 days to 60·0 per cent at 90 days (P = 0·010). At 90 days there was no significant difference between median adhesion coverage of Parietene Composite® (35·0 per cent), Omyramesh® (42·5 per cent), Sepramesh® (60·0 per cent) and Parietene® (72·5 per cent). After 90 days the adhesion coverage of Strattice® was 5·0 per cent, and incorporation (13·4 per cent) was significantly poorer than for other non-infected meshes (P ≤ 0·009). Dualmesh® showed shrinkage of 63 per cent after 90 days.
Parietene Composite® and Omyramesh® performed well in a contaminated environment. Strattice® had little adhesion formation and no mesh infection, but poor incorporation. Some synthetic meshes can be as resistant to infection as biological meshes. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.