The influence of porosity on the integration histology of two polypropylene meshes for the treatment of abdominal wall defects in dogs

Abstract

Two types of monofilament polypropylene mesh with different pore sizes, mass densities and burst strengths were used to repair two identical paired full-thickness abdominal wall defects in ten dogs, in order to compare their integration histology 90 days after implantation. On one side a standard mesh, Prolene (Ethicon), was sutured to the borders of the defect, while on the other a new ultralightweight macroporous mesh, Mpathy mesh, was used. There was a significantly greater densitometric proportion of mature (type I) collagen (58.38%) for Mpathy mesh compared to Prolene (34.05%, P=0.01). Although Prolene has 3.6 times the burst strength of Mpathy mesh, the implanted tissue strength was marginally greater for Mpathy mesh. We conclude that Mpathy mesh gives a surgical repair that is at least as strong as that provided by Prolene, along with a higher concentration of mature collagen and less fibrosis (P=0.07), in this canine histology model.

Polypropylene mesh and the host response

“…In a more recent study by Greca et al, Prolene® was compared with an ultralightweight macroporous PP mesh (Mpathy®; pore size 1.6 -2 mm with interstitial pores 100 μm) [75]. Prolene® had a preimplantation burst strength that was 3.6 times greater than that of Mpathy®; however, at 90 days postimplantation, both meshes demonstrated similar tensile strengths.…”

Prolene mesh mentoplasty

“…Of all the synthetic meshes available, prolene mesh which is still the mesh most commonly used in the repair of hernias, is macroporous, non-absorbable, non-carcinogenic and suitable for sterilization without modifying its qualities and it gives good clinical outcomes [2]. The mesh material's pore size and multi-Wlamentous or mono-Wlamentous natures are important for scar formation.…”

“…The above-mentioned types of alloplastic materials have all their own disadvantages and in order to reduce extrusion rates of the implanted material, an ideal implant should not produce excess foreign body reaction; it should also be chemically inert, noncarcinogenic, nonallergenic, act as a scaVold for new collagen formation in case of a healthy healing, and be suitable for sterilization without modifying its qualities [2].…”

Regeneration of abdominal wall musculofascial defects by a human acellular collagen matrix

“…Typically the meshes are made of one of three basic prosthetic materials: polypropylene (Pro), polyester (Mers), or expanded polytetrafluoroethylene. Despite favourable reports from Usher, who introduced the Pro mesh in 1958, surgeons were initially reluctant to use it, perhaps because of the poor results previously obtained with metallic meshes and fear of infection, which may persist when such a foreign body is present [4,6,7]. This type of mesh is now the most frequently used prosthetic material for ventral hernia repair.…”

“…Recurrence rates after this procedure range from 10% to 50% with considerable morbidity and mortality [1e3]. Additionally, discomfort, delay in returning to work, and the introduction of a laparoscopic approach have led surgeons to apply synthetic meshes [4].…”