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Abstract

Background:

The aim was to study the long-term tissue response to polypropylene mesh.

Methods:

This was a retrieval study that investigated 76 polypropylene meshes with a median implantation interval of 18 (range 2–180) months. Mesh was explanted following hernia recurrence, infection or pain. The median implantation interval was 20 (range 4–180) months in the recurrence group, 30 (range 5–48) months in the pain group and 10 (range 2–56) months in the infection group (P < 0·05, infection versus pain or recurrence). The inflammatory response was determined by immunohistochemistry of macrophages (CD68), polymorphonuclear granulocytes (CD15) and T and B lymphocytes (CD3 and CD20). The cell turnover within the interface mesh fibre–recipient tissue was measured by TUNEL for apoptosis or DNA strand breaks, Ki67 for cell proliferation and heat-shock protein (HSP) 70 for cell stress.

Results:

With the exception of HSP-70, levels of all variables decreased over time. Sex, age, type of previous operation or location of the mesh did not have a significant influence.

Conclusion:

Long-term incorporated polypropylene mesh in humans has a more favourable tissue response with increasing implantation interval. © 2002 British Journal of Surgery Society Ltd