PVDF as a new polymer for the construction of surgical meshes.
Abdominal hernia repair is the most frequently performed operation in surgery. Mostly due to lowered recurrence rates mesh repairs in hernia surgery have become an integral component despite increasing mesh-related complications. Current available mesh prosthesis are made of polypropylene (PP). polyethylene-terephtalat or polytetrafluorethylene. though all of them reveal some disadvantages. The introduction of new materials seems to be advisable. Caused by supposed advantageous textile properties and tissue response two mesh modifications made of polyvinylidene fluoride (PVDF) for abdominal hernia repair were developed. In the present study the PVDF meshes were compared to a common heavy weight PP-mesh (Prolene) in regard to functional consequences and morphological tissue response. After implantation in rats as inlay for 3, 14, 21, 42 and 90 days abdominal wall mobility was recorded by three-dimensional photogrammetry. Tensile strength of the suture zone and the mesh itself were determined. Explanted tissue samples have been investigated for their histological reaction in regard to the inflammatory infiltrate. vascularisation, connective and fat tissue ingrowth. Number of granulocytes, macrophages, fibroblasts, lymphocytes and foreign giant body cells have been evaluated to reflect quality of tissue response. The cellular response was grasped by measurement of DNA strand breaks and apoptosis (TUNEL), proliferation (Ki67) and cell stress (HSP70). Analyzing the results confirmed that construction of hernia meshes made of PVDF could be an advantageous alternative to the commonly used materials due to an improved biostability. lowered bending stiffness and a minimum tissue response.
Klinge
U
U
Department of Surgery, Technical University of Aachen, Germany. uklinge@post.klinikum.rwth-aachen.de
Klosterhalfen
B
B
Ottinger
A P
AP
Junge
K
K
Schumpelick
V
V
D000818:Animals; D005347:Fibroblasts / Q000502:physiology; D006098:Granulocytes / Q000502:physiology; D008264:Macrophages / Q000502:physiology; D008297:Male; D008567:Membranes, Artificial; D011145:Polyvinyls / Q000737:chemistry*; D011312:Pressure; D051381:Rats; D017208:Rats, Wistar; D013329:Structure-Activity Relationship; D013499:Surface Properties; D013526:Surgical Mesh; D013718:Tensile Strength; D013784:Textiles; D014894:Weights and Measures; D005465:Fluorocarbon Polymers
D008567:Membranes, Artificial; D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers