Polypropylene and polypropylene/polyglecaprone (Ultrapro(r)) meshes in the repair of incisional hernia in rats

Abstract

PURPOSE:To compare the inflammatory response of three different meshes on abdominal hernia repair in an experimental model of incisional hernia. METHODS:Median fascial incision and skin synthesis was performed on 30 Wistar rats. After 21 days, abdominal hernia developed was corrected as follows: 1) No mesh; 2) Polypropylene mesh; and, 3) Ultrapro ® mesh. After 21 days, the mesh and surrounding tissue were submitted to macroscopic (presence of adhesions, mesh retraction), microscopic analysis to identify and quantify the inflammatory and fibrotic response using a score based on a predefined scale of 0-3 degrees, evaluating infiltration of macrophages, giant cells, neutrophils and lymphocytes. RESULTS:No significant difference was seen among groups in adherences, fibrosis, giant cells, macrophages, neutrophils or lymphocytes (p>0.05). Mesh shrinkage was observed in all groups, but also no difference was observed between polypropylene and Ultrapro mesh (7.0±9.9 vs. 7.4±10.1, respectively, p=0.967). Post-operatory complications included fistula, abscess, dehiscence, serohematic collection and reherniation, but with no difference among groups (p=0.363). CONCLUSION:There is no difference between polypropylene (high-density) and Ultrapro ® (low-density) meshes at 21 days after surgery in extraperitoneal use in rats, comparing inflammatory response, mesh shortening, adhesions or complications.

Comparative study of Polypropylene versus Parietex composite®, Vicryl® and Ultrapro® meshes, regarding the formation of intraperitoneal adhesions

“…In the United States, incisional hernia is the most common surgical complication 2,3 . Treatment options are fascial repair with tissue reapproximation and suture, or repair with the use of surgical mesh, implemented by Usher in 1958 4,5 .…”

“…Utiyama et al 3 concluded that Ultrapro® and polypropylene have similar results concerning the inflammatory response, adhesion formation, mesh contraction, and complications in rats, with extraperitoneal use.…”

Histopathological and mechanical properties of different meshes in a rat model of pelvic prolapse surgery

“…However, they reported no reduction with porcine dermis and polypropylene (SPARC) when compared with other mesh materials. Utiyama et al (10) reported similar collapse rates for polypropylene (high density) and UltraPro (low density) in a rat hernia repair model. In our study, we observed no statistical reduction in postoperative shrinkage rates for all mesh groups when compared with preoperative baseline rates.…”

“…However, there was reportedly an increased rate of adhesions in tissue after use of polypropylene mesh materials (15,16). Utiyama et al (10) reported that polypropylene (high density) and UltraPro (low density) showed the same results for inflammatory reactions, shrinkage rate, adhesions, and complication rates in a rat hernia repair model. Yildirim et al (17) reported that use of tension-free vaginal tape (TVT, polypropylene monoflament, 75 um), intravaginal slingplasty (IVS, polypropylene Fig.…”

“…Paraffin wax blocks were cut into 4-mm-thick sections with the use of a microtome (Leica RM2125RTS, Leica Biosystems Nussloch GmbH) and stained with hematoxylin-eosin and Masson trichrome. Inflammation, granulocyte, macrophage, lymphocyte, fibroblast, collagen density, and vascularity parameters were scored as reported in a previous study (10). The score was 0 if there was no reaction around the tissue, 1 if there was a less than 25% involvement, 2 if 25%-50%, 3 if 50%-75%, and 4 if more than 75%.…”