Behaviour of biological meshes in a rat model

R. Kaufmann, A.P. Jairam, I.M. Mulder, Z. Wu, J. Verhelst, S. Vennix, L.J.X. Giessen, J. Jeekel, J.F. Lange

Moderator(s): Rene Fortelny (Vienna, Austria) & Salvador Morales Conde (Sevilla, Spain)

11:45 - 12:00h at Jurriaanse Zaal

Categories: Session 2. Experimental research

Parallel session: Session 2. Experimental research

Abdominal wall hernia is almost always treated with a mesh prosthesis. Despite the large variety of mesh prosthesis available, there is only limited knowledge on their in vivo behaviour. Especially biological meshes are said to have many advantages, but are also very expensive. These meshes are therefore rarely used, so little is known about long-term results. We used a physiologic rat model and tested both biological meshes and conventional synthetic meshes to assess the in vivo characteristics of these prostheses.

We operated 5 groups of 24 male Wistar rats each. A mesh was implanted intraperitoneally and fixated with 6 non-resorbable sutures. The following five meshes were implanted: PermacolTM (cross-linked collagen), StratticeTM (non- cross-linked collagen), XCMTM Biologic (non- cross-linked collagen), Omyra® (c-PTFE), and ParieteneTM (polypropylene). Subsequently, the rats were sacrificed after 30, 90, and 180 days. At sacrifice , the following parameters were assessed: ingrowth and shrinkage of the mesh, adhesion coverage and strength of adhesions.

All animals thrived postoperatively. After 180 days, PermacolTM, ParieteneTM and Omyra® had a significantly better ingrowth than StratticeTM (p=0.001, p=0.019 and p=0.037 respectively). StratticeTM had significantly fewer adhesions on the surface of the mesh than ParieteneTM (p<0.001), Omyra® (p=0.011) and PermacolTM (p=0.027). After 30 days, PermacolTM led to significantly stronger adhesions than StratticeTM (p=0.03). However, this difference was not significant anymore after 180 days. After 180 days, there was significantly fewer shrinkage in PermacolTM than in StratticeTM (p=0.001) and Omyra® (p=0.050).

Based on ingrowth, adhesion surface, adhesion strength and mesh shrinkage, ParieteneTM, PermacolTM, and XCMTM Biologic performed best in this experiment in a physiologic rat model.

Biological mesh, synthetic mesh, intraperitoneal mesh, incisional hernia.