[Pathology of traditional surgical nets for hernia repair after long-term implantation in humans].
The widespread use of alloplastic materials as the standard procedure for hernia repair makes an evaluation of the long-term integration of these implants imperative. A total of 121 explanted meshes (mean implantation time 23.2 & 19.7 months) of polypropylene (Atrium((R)), n = 20; Marlex((R)), n = 50; Prolene((R)), n = 21), Polyester (Mersilene((R)), n = 19) and PTFE (Gore-Tex((R)), n = 11) were analyzed in regard to the tissue and cell response within the interface mesh-fiber/tissue. The mesh samples were investigated by light and electronmicroscopy, as well as immunohistochemistry. The morphometric results confirmed a persisting inflammatory proliferative foreign-body reaction with increased cell turnover in the recipient tissues. This reaction is mainly influenced by the selected mesh modification. The consequences of the arising "chronic wound" are discussed in detail, in particular with regard to possible malignant transformation.
Klosterhalfen
B
B
Institut für Pathologie (Direktor: Prof. Dr. C. Mittermayer) der RWTH Aachen. klosterhalfen@pat.rwth-aachen.de
Klinge
U
U
Hermanns
B
B
Schumpelick
V
V
D000328:Adult; D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000209:etiology; D059685:Herniorrhaphy; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects*; D013997:Time Factors
D011093:Polyethylene Terephthalates; D011126:Polypropylenes; C025539:Lavsan; D011138:Polytetrafluoroethylene