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Hernia (2012) 16:6976DOI 10.1007/s10029-011-0854-5
ORIGINAL ARTICLE
Comparison of contracture, adhesion, tissue ingrowth, and histologic response characteristics of permanent and absorbable barrier meshes in a porcine modelof laparoscopic ventral hernia repair
C. R. Deeken B. D. Matthews
Received: 17 February 2011 / Accepted: 24 June 2011 / Published online: 12 July 2011 Springer-Verlag 2011
AbstractPurpose The objective of this study was to determine the mesh contracture, adhesion, tissue ingrowth, and histologic characteristics of a novel absorbable barrier mesh (VentrioTM
ST Hernia Patch) compared to existing permanent (VentrioTM Hernia Patch) and absorbable barrier meshes (SeprameshTM IP Composite and PROCEEDTM Surgical Mesh).
Methods Standard laparoscopic technique was utilized to bilaterally implant meshes in 20 female Yorkshire pigs (n = 5 pigs/group). Meshes were xated to the intact peritoneum with SorbaFixTM absorbable xation devices. Mesh contracture, adhesion coverage, and adhesion tenacity were evaluated after 4 weeks. T-Peel testing and hematoxylin and eosin (H&E) staining were utilized to assess tissue ingrowth and host response.
Results A signicantly greater percent area contracture was demonstrated for PROCEEDTM (26.9%) compared to VentrioTM ST (8.8%), VentrioTM (14.5%) and SeprameshTM(9.2%). VentrioTM ST demonstrated similar adhesion area, tenacity, and tissue ingrowth compared to all other meshes. Histological scoring revealed a comparable host inammatory response for all meshes, with a few exceptions. A greater number of giant cells were observed in VentrioTM
ST and SeprameshTM near the multilament polyglycolic acid (PGA) bers; a greater number of macrophages were observed in PROCEEDTM compared to VentrioTM;
and a greater number of neutrophils were observed in PROCEEDTM, compared to SeprameshTM (P \ 0.05). Focal areas of hemorrhage were also observed on the visceral surface of PROCEEDTM.
Conclusions VentrioTM ST Hernia Patch demonstrated comparable contracture, adhesion, tissue ingrowth, and histologic characteristics compared to existing permanent and absorbable barrier meshes. Host inammatory and brotic responses for all four meshes were minimal and representative of a biocompatible response.
Keywords Adhesion Tissue ingrowth Absorbable
barrier mesh Permanent barrier mesh Ventral hernia
Introduction
It is estimated that greater than 90% of patients develop adhesions as a part of the wound healing response following abdominal surgery [1]. Injury to the peritoneum can occur due to a number of factors such as mechanical trauma during the surgical procedure, infection, dessication from pneumoperitoneum during laparoscopy, or the presence...