Skip to main content

Advertisement

SpringerLink
Log in

Experimental study comparing meshes made of polypropylene, polypropylene + polyglactin and polypropylene + titanium: inflammatory cytokines, histological changes and morphometric analysis of collagen

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

Incisional hernia occurs in approximately 11% of all laparotomies. Changes in collagen have been closely implicated in its pathogenesis. The high recurrence rate (45–54%) after primary suture has stimulated the development of meshes. Currently, meshes are the biomaterials implant group most used in medicine. This study aims to compare the serum and tissue inflammatory responses and collagen deposition caused by meshes made of polypropylene, polypropylene + polyglactin and polypropylene + titanium.

Methods

Thirty Wistar rats were divided into three groups. In group I, a high-density polypropylene mesh was positioned on the abdominal wall. In groups II and III, low-density meshes were used in associations with polyglactin and titanium, respectively. Immediately before the operation and on the first, third and fortieth postoperative days, pro-inflammatory cytokines were assayed. On the 40th postoperative day, the region of the inserted prosthesis was biopsied. The tissue inflammatory reaction was evaluated using a scale for objective scoring. For collagen, picrosirius was used with data reading using the Image Tool computer software.

Results

Cytokines: there were no statistically significant differences between the groups. Histology: on the 40th postoperative day in group I, there were fewer inflammatory tissue response and greater collagen deposition (P < 0.01). In group II, there were greater inflammatory tissue response and less collagen deposition (P < 0.01). Group III presented intermediate values between groups I and II.

Conclusions

There were no significant differences in cytokine levels between the groups in the present study. In the animals with the polypropylene + polyglactin mesh implant there was the most intense inflammatory process with lower tissue maturation and collagen deposition on the 40th postoperative day. The polypropylene mesh presented a less severe late inflammatory process, with greater tissue maturation and collagen deposition. The polypropylene + titanium mesh presented intermediate values between the others.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Derek AD, Wang X, Adamson B, Kuzon WM Jr, Dennis RG, Franz MG (2006) Mesh incisional herniorrhaphy increases abdominal wall elastic properties: a mechanism for decreased hernia recurrences in comparison with suture repair. Surg 140:14–24

    Article  Google Scholar 

  2. Lawson-Smith MJ, Galland RB (2006) Combined fascia and mesh repair of incisional hernias. Hernia 10:262–265

    Article  CAS  PubMed  Google Scholar 

  3. Junge K, Junge U, Klosterhalfen B, Mertens PR, Rosch R, Schchtrupp A, Ulmer F, Schumpelik V (2002) Influence of mesh materials on collagen deposition in a rat model. J Inv Surg 15:319–328

    Article  CAS  Google Scholar 

  4. Gonzalez R, Fugate McCluskyD, Ritter EM, Lederman A, Dillehay D, Smith CD, Ramshaw BJ (2005) Relationship between tissue ingrowth and mesh contraction. World J Surg 29:1038–1043

    Article  PubMed  Google Scholar 

  5. Di Vita G, D’Agostinho P, Patti R, Arcara M, Caruso G, Davi V, Cillari E (2005) Acute inflammatory response after inguinal and incisional hernia repair with implantation of polypropylene mesh of different size. Langenbecks Arch Surg 390:306–311

    Article  PubMed  Google Scholar 

  6. Klosterhalfen B, Junge K, Klinge U (2005) The lightweight and large porous mesh concept for hernia repair. Expert Rev Med Devices 2:103–117

    Article  PubMed  Google Scholar 

  7. Jungle K, Klinge U, Prescher A, Giboni P, Niewiera M, Schumpelick V (2001) Elasticity of the anterior abdominal wall and impact for reparation of incisional hernias using mesh implats. Hernia 5:113–118

    Article  Google Scholar 

  8. Weyhe D, Belyaev O, Muller C, Meurer K, Bauer K, Papapstolou G, Uhl W (2007) Improving outcomes in hernia repair by the use of the light meshes–a comparison of different implant constructions based on a critical appraisal of the literature. World J Surg 31:234–244

    Article  PubMed  Google Scholar 

  9. Harrell AG, Novitsky YW, Cristiano JA, Gersin KS, Norton HJ, Kercher KW, Heniford BT (2007) Prospective histologic evaluation of intra-abdominal prosthetics 4 months after implantation in a rabbit model. Surg Endosc 21:1170–1174

    Article  PubMed  Google Scholar 

  10. Derek AD, Wang X, Kirk S, Adamson B, Robson MC, Franz MG (2004) Fascial fibroblast kinetic activity in increased during abdominal wall repair compared to dermal fibroblasts. Wound Rep Reg 12:539–545

    Article  Google Scholar 

  11. Derek AD, Wang X, Kuhn A, Robson MC, Franz MG (2004) The prevention of incisional hernia formation using a delayed-release polymer of basic fibroblast growth factor. Ann Surg 240:179–186

    Article  Google Scholar 

  12. Di Vita G, Patti R, D’Agostinho P, Arcoleo F, Caruso G, Arcara M, Davi V, Cillari E (2005) Serum VEGF and b-FGF profiles after tension-free or conventional hernioplasty. Langenbecks Arch Surg 390:528–533

    Article  PubMed  Google Scholar 

  13. Sedov VM, Tarbaev SD, Gostevskoi AA, Gorelov AS (2005) Effectiveness of hernioplasty with using a polypropylene mesh implant in treatment of postoperative ventral hernias. Vestn Khir Im I I Grek 164:85–87

    CAS  PubMed  Google Scholar 

  14. Robson MC, Derek AD, Wang X, Franz MG (2003) Effect of cytokine growth factors on the prevention of acute wound failure. Wound Rep Reg 12:38–43

    Article  Google Scholar 

  15. Korenkov M, Yucel N, Koebke J, Schierholz J (2005) Local administration of TGF-b1 to reinforce the anterior abdominal wall in a rat model of incisional hernia. Hernia 9:252–258

    Article  CAS  PubMed  Google Scholar 

  16. Vaz M, Krebs RK, Trindade EN, Trindade MR (2009) Fibroplasia after polypropylene mesh implantation for abdominal wall hernia repair in rats. Acta Cir Bras 24:19–25

    Article  PubMed  Google Scholar 

  17. Vyslouzil K, Klementa I, Stary L, Duda M, Zboril P, Skalicky P, Dlouhy M (2005) The intra-abdominally located mesh in the laparotomy management of major hernias. Rozhl Chir 84:310–313

    CAS  PubMed  Google Scholar 

  18. White TJ, Santos MC, Thompson JS (1998) Factors affecting wound complications in repair of ventral hernias. Am Surg 64:276–280

    CAS  PubMed  Google Scholar 

  19. Birolini C, Mazzuchi E, Utiyuama EM, Nahas W, Rodrigues AJ, Arap S, Birolini D (2001) Prosthetic repair of incisional hernia in kidney transplant patients, a technique with onlay polypropylene mesh. Hernia 5:31–35

    Article  CAS  PubMed  Google Scholar 

  20. Goldenberg A, Matone J, Marcondes W, Herbella FAM, Farah JFM (2005) Comparative study of inflammatory response and adhesions formation after fixation of different meshes for inguinal hernia repair in rabbits. Acta Cir Bras 20:347–352

    PubMed  Google Scholar 

  21. Post S, Weiss B, Willer M, Neufang T, Lorenz D (2002) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Annual Congress 2002 of the German Surgical Society May, Berlin, Germany

  22. O’Dwyer PJ, Kingsnorth AN, Molloy RG, Small PK, Lammers B, Hieryseck G (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

    Article  PubMed  Google Scholar 

  23. Scheidbach H, Tamme C, Tannapfel A, Lippert H, Köckerling F (2004) In vivo studies comparing the biocompatibility of various polypropylene meshes and their handling properties during endoscopic total extraperitoneal (TEP) patchplasty: an experimental study in pigs. Surg Endosc 18:211–220

    Article  CAS  PubMed  Google Scholar 

  24. White MB, Barbul A (1997) General principles of wound healing. Surg Clin N Am 77:509–528

    Article  Google Scholar 

  25. Chatzimavroudis G, Koutelidakis I, Papaziogas B, Tsaganos T, Koutoukas P, Giamarellos-Bourboulis E, Atmatzidis S, Atmatzidis K (2008) The effect of the type of intraperitoneally implanted prosthetic mesh on the systemic inflammatory response. Hernia 12:277–283

    Article  CAS  PubMed  Google Scholar 

  26. Klinge U, Klosterhalfen B, Birkenhauer V, Junge K, Conze J, Schumpelick V (2002) Impact of polymer pore size on the interface scar formation in a rat model. J Surg Res 103:208–214

    Article  CAS  PubMed  Google Scholar 

  27. Junge K, Klinge U, Rosch R, Klosterhalfen B, Schumpelick V (2002) Functional and morphologic properties of a modified mesh for inguinal hernia repair. World J Surg 26:1472–1489

    Article  PubMed  Google Scholar 

  28. Rosch R, Junge K, Quester R, Klinge U, Schumpelick V, Klosterhalfen B (2003) Vypro II mesh in hernia repair: impact of polyglactin on long-term incorporation in rats. Eur Surg Res 2003:445–450

    Article  Google Scholar 

  29. Junge K, Rosch R, Kllinge U, Saklak M, Klosternhalfen B, Peiper C, Schumpelick V (2005) Titanium coating of a polypropylene mesh for hernia repair: effect on biocompatibility. Hernia 9:115–119

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study had a sponsor by the Fundação de Pesquisa de São Paulo—FAPESP (protocol 07/57100-6). The authors do not have a financial relationship with the organization that sponsored the research.

Conflict of interest statement

The authors declare that they have no conflict of interest in this research.

Author information

Authors and Affiliations

  1. Pós-Graduação de Gastroenterologia Cirúrgica, Universidade Federal de São Paulo, Rua Napoleão de Barros, 610-Vila Clementino, São Paulo, SP, CEP 04024-002, Brazil

    C. G. Pereira-Lucena, R. Artigiani-Neto, G. J. Lopes-Filho, C. V. G. Frazao, A. Goldenberg, D. Matos & M. M. Linhares

  2. Rua Pedro de Toledo, N-980, Cj-152, São Paulo, SP, CEP 04039-002, Brazil

    M. M. Linhares

Authors
  1. C. G. Pereira-Lucena
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Artigiani-Neto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. J. Lopes-Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. V. G. Frazao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Goldenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. Matos
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. M. Linhares
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. M. Linhares.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pereira-Lucena, C.G., Artigiani-Neto, R., Lopes-Filho, G.J. et al. Experimental study comparing meshes made of polypropylene, polypropylene + polyglactin and polypropylene + titanium: inflammatory cytokines, histological changes and morphometric analysis of collagen. Hernia 14, 299–304 (2010). https://doi.org/10.1007/s10029-009-0621-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-009-0621-z

Keywords

Search

Navigation