Between Prolene®, Ultrapro® and Bard Soft® Meshes Which Presents the Best Performance in the Repair of the Abdominal Wall?

Utrabo, Carlos Alberto Lima; Czeczko, Nicolau Gregori; Busato, Cesar Roberto; Netto, Mário Rodrigues Montemór; Lipinski, Leandro Cavalcante; Malafaia, Osvaldo

doi:10.1590/0102-672020210001e1577

Cited by 5 publications

(7 citation statements)

References 26 publications

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“…This result was similar to the ones by Ultrabo et al . 25 , who did not find statistically significant differences in the inflammatory reaction score after 30 days of preperitoneal implantation in rats with micro and macroporous polypropylene and macroporous polypropylene with poliglecaprone meshes. The presence of a synthetic mesh with or without a tissue separating barriers implies a more intense and prolonged inflammatory response than the simple suture of the median aponeurosis of the abdominal wall using a polyglactin suture.…”

Section: Discussionmentioning

confidence: 87%

Analysis of tissue inflammatory response, fibroplasia, and foreign body reaction between the polyglactin suture of abdominal aponeurosis in rats and the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone and polyester/porcine collagen meshes

et al. 2021

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Purpose To compare tissue inflammatory response, foreign body reaction, fibroplasia, and proportion of type I/III collagen between closure of abdominal wall aponeurosis using polyglactin suture and intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes to repair defects in the abdominal wall of rats. Methods Forty Wistar rats were placed in four groups, ten animals each, for the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes or suture with polyglactin (sham) after creation of defect in the abdominal wall. Twenty-one days later, histological analysis was performed after staining with hematoxylin-eosin and picrosirius red. Results The groups with meshes had a higher inflammation score (p < 0.05) and higher number of gigantocytes (p < 0.05) than the sham group, which had a better fibroplasia with a higher proportion of type I/III collagen than the tissue separating meshes (p < 0.05). There were no statistically significant differences between the three groups with meshes. Conclusions The intraperitoneal implant of polypropylene/polyglecaprone and polyester/porcine collagen meshes determined a more intense tissue inflammatory response with exuberant foreign body reaction, immature fibroplasia and low tissue proportion of type I/III collagen compared to suture with polyglactin of abdominal aponeurosis. However, there were no significant differences in relation to the polypropylene mesh group.

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Section: Discussionmentioning

confidence: 87%

Analysis of tissue inflammatory response, fibroplasia, and foreign body reaction between the polyglactin suture of abdominal aponeurosis in rats and the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone and polyester/porcine collagen meshes

et al. 2021

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“…The incorporation and the inflammatory reaction in tissue can be predicted according to the pore size, the design of filaments, and their spatial distribution. It has been described that polypropylene meshes with large pore size and low weight can reduce fibrosis formation and persistency [ 27 ]. In the present study, we used macroporous polypropylene (Bard ® Mesh-BD, Franklin Lakes, NJ, USA) that has been described as a resistant material, able to avoid dehiscence in the period after the surgery (30 and 60 days) if compared to other meshes with different weights and pore size [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…It has been described that polypropylene meshes with large pore size and low weight can reduce fibrosis formation and persistency [ 27 ]. In the present study, we used macroporous polypropylene (Bard ® Mesh-BD, Franklin Lakes, NJ, USA) that has been described as a resistant material, able to avoid dehiscence in the period after the surgery (30 and 60 days) if compared to other meshes with different weights and pore size [ 27 ]. Moreover, the large pore size permits the penetration of fibroblast that can assure proper incorporation of the mesh [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, we used macroporous polypropylene (Bard ® Mesh-BD, Franklin Lakes, NJ, USA) that has been described as a resistant material, able to avoid dehiscence in the period after the surgery (30 and 60 days) if compared to other meshes with different weights and pore size [ 27 ]. Moreover, the large pore size permits the penetration of fibroblast that can assure proper incorporation of the mesh [ 27 ]. Therefore, the authors cannot exclude that the presence of adhesions can be due to the penetration of fibroblast.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the authors cannot exclude that the presence of adhesions can be due to the penetration of fibroblast. It will be necessary to evaluate the coating of other meshes, such as Ultrapro ® (Ethicon, Raritan, NJ, USA) that has been defined as the best material in the healing process of the abdominal wall [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

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In Vivo Evaluation of a Pectin-Honey Hydrogel Coating on Polypropylene Mesh in a Rat Model of Acute Hernia

Vercelli

Iussich

Odore

et al. 2021

Gels

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Investigations about ventral hernia repair are focused on improving the quality, resistance, and biocompatibility of mesh. This study compared plain polypropylene mesh with a pectin-honey hydrogel-coated polypropylene mesh in an acute hernia model in rats. Forty Wistar rats, randomly assigned to two groups, were submitted to laparotomy, and a 1 cm × 2 cm fascial defect was created, centered on the midline. Uncoated (group C) or coated mesh (group T) was inserted in an inlay fashion to repair the defect. After 30 days, the rats were euthanized, and the presence of adhesions to the mesh was macroscopically evaluated. Histology and measurement of COX-2 as tissue inflammation markers were used to assess fascia tissue healing. Grades of adhesion were not different between groups. Histological score and COX-2 expression were not significantly different between groups, except for the higher inflammatory response demonstrated in group T. The pectin-hydrogel coated mesh could not reduce adhesion formation compared to uncoated polypropylene mesh but improved peritoneal regeneration and tissue healing.

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Lightweight macroporous mesh can be used for corporal reconstruction during penile prosthesis surgery

Lee,

Gordon,

Ralph

2023

The Journal of Sexual Medicine

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Background Options to reinforce or reconstruct the corpora cavernosa during penile prosthesis surgery are limited. Synthetic grafts may confer a higher infection risk. Lightweight macroporous mesh is a promising alternative due to better integration and tissue ingrowth. Aim The study sought to report the first experience of using lightweight mesh to reinforce or reconstruct the corpora. Methods The medical records of all patients undergoing insertion or revision of penile prosthesis between May 2016 and May 2021 were reviewed retrospectively. Patient characteristics, management, and outcomes were extracted in which mesh was used for corporal reconstruction. Poliglecaprone-25/polypropylene mesh (UltraPro) was used in all cases. The surgical technique and alternatives were summarized. Outcomes The outcomes were infection rate, postoperative complications by Clavien-Dindo classification, and patient-reported outcomes. Results Mesh was required during penile prosthesis surgery in 21 men (median age 56 [range, 18-74] years). Reasons for reconstruction were severe corporal fibrosis (n = 6), impending erosion (n = 6), crossover/perforation (n = 6), congenital corporal agenesis (n = 2), and excision of Peyronie’s plaque. All but 2 patients (with corporal agenesis) presented for revision penile prosthesis surgery with a median number of previous revision attempts of 2 (range, 1-5). Two (10%) patients required explant after a mean follow-up of 23 ± 8.7 months. One man developed infection of the device 2 years after surgery, translating to an infection rate of 5% despite a high prevalence of diabetes (25%) in this cohort. Another required explantation due to debilitating chronic pain after 3 months. Further revision surgery for stiction syndrome was required in a third patient. Finally, another man was not satisfied with the position of the pump within the scrotum or the axial rigidity of the device, despite a second opinion suggesting no issues with the device. All men were sexually active following surgery. Clinical implications A lightweight mesh can be considered to reinforce or reconstruct the corpora cavernosa in complex cases in which there are no alternative techniques available. Strengths and limitations This is the first study using a lightweight macroporous mesh for revision penile prosthesis surgery. This was a well-characterized cohort of patients. A larger cohort with 5-year follow-up would be preferable. Conclusion These early results suggest that a lightweight macroporous mesh may be an acceptable synthetic graft for corporal reconstruction. Poliglecaprone-25/polypropylene mesh may be ideal because it is partially absorbable, easy to handle, and not bulky.

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Between Prolene®, Ultrapro® and Bard Soft® Meshes Which Presents the Best Performance in the Repair of the Abdominal Wall?

Cited by 5 publications

References 26 publications

Analysis of tissue inflammatory response, fibroplasia, and foreign body reaction between the polyglactin suture of abdominal aponeurosis in rats and the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone and polyester/porcine collagen meshes

Analysis of tissue inflammatory response, fibroplasia, and foreign body reaction between the polyglactin suture of abdominal aponeurosis in rats and the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone and polyester/porcine collagen meshes

In Vivo Evaluation of a Pectin-Honey Hydrogel Coating on Polypropylene Mesh in a Rat Model of Acute Hernia

Lightweight macroporous mesh can be used for corporal reconstruction during penile prosthesis surgery

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