Abstract
Introduction
Differences in mesh composition may affect outcomes such as erosion, tissue integration and inflammation. The majority of commercially available meshes are type 1, manufactured from monofilament polypropylene with differing pore sizes and mechanical properties.
Objective
To assess the local tolerance of four commercially available meshes in terms of mesh integration and host tissue response.
Method
Using an animal model, mesh was implanted onto the abdominal sheath. Animals were sacrificed at 7, 30 and 90 days and data collected.
Results
Strength of mesh-skin integration increased in all groups across the three time points. Polyform displayed highest strength of separation overall. VM PFR and Iprolite reached their maximum integration earliest. In regard to mesh abdominal wall integration Polyform had the greatest strength of separation, with Ultrapro displaying some weakening of integration at 30 and 90 days. Host tissue response was similar in all groups at each time point.
Conclusion
Polyform and VM PFR have enhanced tissue integration when compared to Ultrapro. This decreased integration in Ultrapro may lead to increased mesh failure. The composition of mesh affects its integration and potentially its failure rate but not host tissue response. These observations in mesh characteristics may benefit the design of next generation meshes with a view to reducing failure rates and erosion.
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Conflict of interest
This study was co-sponsored by Boston Scientific Corporation and Proxy Biomedical Limited. Dr O’Reilly acts as an advisor to Proxy Biomedical Limited, with no financial benefit.
Ethical approval
The study was granted ethical approval using Institutional Animal Care and Use Committee (IACUC) protocol number 2006-0147 at Case Western Reserve University, Cleveland, Ohio, USA.
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O’Sullivan, O.E., Connor, J. & O’Reilly, B.A. Lightweight meshes: evaluation of mesh tissue integration and host tissue response. Arch Gynecol Obstet 289, 1029–1037 (2014). https://doi.org/10.1007/s00404-013-3093-4
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DOI: https://doi.org/10.1007/s00404-013-3093-4