Three-year results from a preclinical implantation study of a long-term resorbable surgical mesh with time-dependent mechanical characteristics
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The purpose of this study was to evaluate the biocompatibility, local tissue effects and performance of a synthetic long-term resorbable test mesh (TIGR® Matrix Surgical Mesh) compared to a non-resorbable polypropylene control mesh following implantation in a sheep model.
Full-thickness abdominal wall defects were created in 14 sheep and subsequently repaired using test or control meshes. Sacrifices were made at 4, 9, 15, 24 and 36 months and results in terms of macroscopic observations, histology and collagen analysis are described for 4, 9, 15, 24 and 36 months.
The overall biocompatibility was good, and equivalent in the test and control meshes while the resorbable mesh was characterized by a collagen deposition more similar to native connective tissue and an increased thickness of the integrating tissue. The control polypropylene mesh provoked a typical chronic inflammation persistent over the 36-month study period. As the resorbable test mesh gradually degraded it was replaced by a newly formed collagen matrix with an increasing ratio of collagen type I/III, indicating a continuous remodeling of the collagen towards a strong connective tissue. After 36 months, the test mesh was fully resorbed and only microscopic implant residues could be found in the tissue.
This study suggests that the concept of a long-term resorbable mesh with time-dependent mechanical characteristics offers new possibilities for soft tissue repair and reinforcement.
- Wolstenholme JT (1956) Use of commercial dacron fabric in the repair of inguinal hernias and abdominal wall defects. AMA Arch Surg 73:1004–1008 CrossRef
- Usher FC, Ochsner J, Tuttle LL Jr (1958) Use of marlex mesh in the repair of incisional hernias. Am Surg 24:969–974
- Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193 CrossRef
- Klinge U, Klosterhalfen B, Müller M, Schumpelick V (1999) Foreign body reactions to meshes used for the repair of abdominal wall hernias. Eur J Surg 165:665–673 CrossRef
- Szpaderska AM, DiPietro LA (2005) Inflammation in surgical wound healing: friend or foe? Surgery 137:571–573 CrossRef
- O’Dwyer PJ, Kingsnorth AN, Molloy RG, et al. (2005) Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair. Br J Surg 92:166–170
- Post S, Weiss B, Willer M et al (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48 CrossRef
- Smietański M, Bury K, Smietańska IA et al. (2011) Five-year results of a randomized controlled multi-centre study comparing heavy-weight knitted versus low-weight, non-woven polypropylene implants in Lichtenstein hernioplasty. Hernia. doi:10.1007/s10029-011-0808-y
- Blatnik J, Jin J, Rosen M (2008) Abdominal hernia repair with bridging acellular dermal matrix—an expensive hernia sac. Am J Surg 196:47–50 CrossRef
- Lange DA, Zaret P, Merlotti GJ, Robin AP, Sheaff C, Barrett JA (1988) The use of absorbable mesh in splenic trauma. J Trauma 28:269–275 CrossRef
- Delany HM, Rudavsky AZ, Lan S (1985) Preliminary clinical experience with the use of absorbable mesh splenorrhaphy. J Trauma 25:909–913 CrossRef
- Jernigan TW, Fabian TC, Croce MA et al (2003) Staged management of giant abdominal wall defects. Ann Surg 238:349–357
- Efthimiou M, Symeonidis D, Koukoulis G et al (2011) Open inguinal hernia repair with the use of a polyglycolic acid-trimethylene carbonate absorbable mesh: a pilot study. Hernia 15:181–184 CrossRef
- de Tayrac R, Chentouf S, Garreau H et al (2008) In vitro degradation and in vivo biocompatibility of poly(lactic acid) mesh for soft tissue reinforcement in vaginal surgery. J Biomed Mater Res B Appl Biomater 85:529–536
- de Tayrac R, Letouzey V, Garreau H et al (2010) Tissue healing during degradation of a long-lasting bioresorbable gamma-ray-sterilised poly(lactic acid) mesh in the rat: a 12-month study. Eur Surg Res 44:102–110 CrossRef
- Klinge U, Schupelick V, Klosterhalfen B (2001) Functional assessment and tissue response of short- and long-term absorbable surgical meshes. Biomaterials 22:1415–1424 CrossRef
- Rubert JW, Hallab NJ (2005) Strain-controlled enzymatic cleavage of collagen in loaded matrix. Biochem Biophys Res Commun 336:483–489 CrossRef
- Junquiera LC, Cossermelli W, Brentani R (1978) Differential staining of collagens type I, II and III by Sirius red and polarization microscopy. Arch Histol Jpn 41:267–274 CrossRef
- Poirier J, Ribadeau-Dumas J-L, Catala M, André J-M (1999) Histologie Moléculaire: Texte et Atlas. 1st edn. Masson, Paris
- Middleton JC, Tipton AJ (2000) Synthetic biodegradable polymers as orthopedic devices. Biomaterials 21:2335–2346 CrossRef
- Bailey AJ, Sims TJ, Le Lous M, Bazin S (1975) Collagen polymorphism in experimental granulation tissue. Biochem Biophys Res Commun 66:1160–1165 CrossRef
- Thermann H, Frerichs O, Holch M, Biewener A (2002) Healing of achilles tendon, an experimental study: part 2–histological, immunohistological and ultrasonographic analysis. Foot Ankle Int 23:606–613
- Katou F, Ohtani H, Nagura H, Motegi K (1998) Procollagen-positive fibroblasts predominantly express fibrogenic growth factors and their receptors in human encapsulation process against foreign body. J Pathol 186:201–208 CrossRef
- Chiquet M, Gelman L, Lutz R, Maier S (2009) From mechanotransduction to extracellular matrix gene expression in fibroblasts. Biochim Biophys Acta 1793:911–920 CrossRef
- Three-year results from a preclinical implantation study of a long-term resorbable surgical mesh with time-dependent mechanical characteristics
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