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Abstract

Background:

Implantation of meshes in a contaminated environment can be complicated by mesh infection and adhesion formation.

Methods:

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.

Results:

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.

Conclusion:

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.