Influence of polyglactin-coating on functional and morphological parameters of polypropylene-mesh modifications for abdominal wall repair

Fibroplasia after polypropylene mesh implantation for abdominal wall hernia repair in rats

“…The persistence of neutrophils and macrophages for long time periods indicates a prolonged acute inflammatory process, whereas the early detection of lymphocytes and giant cells and their persistence until the end of the study period indicate a chronic inflammatory process. These findings are consistent with previously reported ones 15,23,24 . In the healing process classically described for skin wounds [10][11][12][13]22 which is the basis for understanding the repair process of other tissues, neutrophils are the first cells to reach the wounded tissue, appearing approximately 24 hours after injury and remaining there for 3 to 5 days.…”

“…Note that lymphocytes reached their maximum infiltration between the 3rd and 7th postoperative days, being in line with previous studies 10 , and gradually decreased thereafter up to the 21st day, remaining at low levels up to the 30th day. Giant cells, which represent a chronic foreign-body-type inflammatory process, were observed on the 2nd day, but their presence was more pronounced after the 7th day, remaining so up to the end of the study period; these findings concur with those previously described 15 . The persistence of neutrophils and macrophages for long time periods indicates a prolonged acute inflammatory process, whereas the early detection of lymphocytes and giant cells and their persistence until the end of the study period indicate a chronic inflammatory process.…”

“…In a study with rats which assessed cellular response to the polypropylene mesh, Klinge et al 24 perceived that the signs of inflammation reached their maximum values between 7 and 14 days. The same author 15 , in another study with rats, reports the presence of giant cells on polypropylene meshes on the 7th postoperative day, whose number increases on the 14th day and continues to rise until the end of the study period, on the 90th day. This author also observed the virtually complete disappearance of the acute inflammatory process and the presence of cellular infiltrate on the 21st day, which is characteristic of chronic inflammation.…”

“…The fibroplasia process consists of a harmonious and coordinated sequence of cellular and molecular events which interact to promote the repair and reconstruction of damaged tissue [10][11][12][13] . Its extent depends on the level of inflammatory activity, one of the healing stages [14][15][16] , and is a prerequisite for the reconstruction of a mechanically stable abdominal wall. Reinforcement of the abdominal wall with polypropylene mesh is achieved by the increase in the tensile strength of the prosthetic material and as a result of fibrotic reaction induced by the mesh.…”

Polyglactine/Polypropylene Mesh vs. Propylene Mesh: Is there a need for newer prosthesis in inguinal hernia?

“…[1314]Flexible light weight meshes with similar elasticity to the abdomen, demonstrate their superiority with respect to a physiologic hernia repair. [15]Modern biomaterials, including polymers, are physically and chemically inert and stable, non-immunogenic and non-toxic. In contradiction to their physical and chemical stability, the biomaterials trigger a variety of adverse responses in vivo including inflammation, fibrosis, calcification and thrombosis.…”