Behaviour of a New Composite Mesh for the Repair of Full-Thickness Abdominal Wall Defects in a Rabbit Model

Abstract

IntroductionComposite biomaterials designed for the repair of abdominal wall defects are composed of a mesh component and a laminar barrier in contact with the visceral peritoneum. This study assesses the behaviour of a new composite mesh by comparing it with two latest-generation composites currently used in clinical practice.MethodsDefects (7x5cm) created in the anterior abdominal wall of New Zealand White rabbits were repaired using a polypropylene mesh and the composites: PhysiomeshTM; VentralightTM and a new composite mesh with a three-dimensional macroporous polyester structure and an oxidized collagen/chitosan barrier. Animals were sacrificed on days 14 and 90 postimplant. Specimens were processed to determine host tissue incorporation, gene/protein expression of neo-collagens (RT-PCR/immunofluorescence), macrophage response (RAM-11-immunolabelling) and biomechanical resistance. On postoperative days 7/14, each animal was examined laparoscopically to quantify adhesions between the visceral peritoneum and implant.ResultsThe new composite mesh showed the lowest incidence of seroma in the short term. At each time point, the mesh surface covered with adhesions was greater in controls than composites. By day 14, the implants were fully infiltrated by a loose connective tissue that became denser over time. At 90 days, the peritoneal mesh surface was lined with a stable mesothelium. The new composite mesh induced more rapid tissue maturation than PhysiomeshTM, giving rise to a neoformed tissue containing more type I collagen. In VentralightTM the macrophage reaction was intense and significantly greater than the other composites at both follow-up times. Tensile strengths were similar for each biomaterial.ConclusionsAll composites showed optimal peritoneal behaviour, inducing good peritoneal regeneration and scarce postoperative adhesion formation. A greater foreign body reaction was observed for VentralightTM. All composites induced good collagen deposition accompanied by optimal tensile strength. The three-dimensional macroporous structure of the new composite mesh may promote rapid tissue regeneration within the mesh.

Comparison of two different concepts of mesh and fixation technique in laparoscopic ventral hernia repair: a randomized controlled trial

“…Searching the PubMed database, we found only few experimental and comparative studies, which were mainly in animal models. Most of the articles show similar results in terms of mechanical properties, adhesion characteristics and histological testing [27][28][29]. The main disadvantage of those studies was the short observation time periods after the mesh implementations, which went from the 14th to the 28th day.…”

Tissue integration and inflammatory reaction in full-thickness abdominal wall repair using an innovative composite mesh

“…Their architecture is perfectly adapted for intraperitoneal placement as the anti-adhesive barrier side prevents postoperative attachment of visceral tissues and the mesh is appropriate for tissue integration in the abdominal wall. In a previous preclinical study [17], we used sequential laparoscopy to evaluate the ability of three distinct composite meshes that differ by architecture and chemical composition to prevent the formation of postoperative adhesions. All composites displayed adequate peritoneal behavior with minimal adhesion formation.…”

“…In a previous study performed by our group [17], we analyzed the behavior of various composite meshes at the peritoneal interface as well as their tissue integration. In that study, the seroma and FBR observed with some of the implants caught our attention.…”

Design strategies and applications of biomaterials and devices for Hernia repair

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