Acute inflammatory response after inguinal and incisional hernia repair with implantation of polypropylene mesh of different size.
BACKGROUND
The purpose of this study was to assess the modifications of interleukin (IL)-6, C-reactive protein (CRP), leukocytes and fibrinogen after implantation of polypropylene mesh.


METHODS
Thirty-six patients were included in this study and divided into two groups. To the first group were allocated patients affected by inguinal hernia and undergoing conventional repair (subgroup Ia) or hernioplasty with 40-cm(2) polypropylene mesh (subgroup Ib). To the second group were allocated patients affected by incisional hernia and undergoing conventional repair (subgroup IIa) or incisional hernia repair with 400-cm(2) polypropylene mesh (subgroup IIb). Peripheral venous blood samples were collected 24 h before surgery and then 6, 24, 48 and 168 h postoperatively.


RESULTS
We present evidence that serum levels of IL-6, CRP, leukocytes and fibrinogen were significantly increased postoperatively in all subgroups compared with their baseline values. In particular, the production of inflammatory mediators was higher in subgroups Ib vs Ia and IIb vs IIa. Comparing the entities of the inflammatory responses among various groups we found that it was clear that they were similar in subgroups Ib and IIa, and that the highest were in subgroup IIb and the lowest in subgroup Ia.


CONCLUSIONS
The data show that conventional inguinal and incisional hernia repair induces an inflammatory response, which is smaller than that observed if both operations are carried out with polypropylene meshes. Furthermore, the results suggest that a larger mesh is associated with a higher production of inflammation mediators.
Di Vita
Gaetano
G
Department of Surgery and Oncology, Division of General Surgery, University of Palermo, Palermo, Italy.
D'Agostino
Pietro
P
Patti
Rosalia
R
Arcara
Matteo
M
Caruso
Giuseppe
G
Davì
Valentina
V
Cillari
Enrico
E
D001672:Biocompatible Materials / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000032:analysis / Q000276:immunology; D005260:Female; D005340:Fibrinogen / Q000032:analysis / Q000276:immunology; D046449:Hernia, Abdominal / Q000601:surgery; D006552:Hernia, Inguinal / Q000601:surgery; D059685:Herniorrhaphy; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology*; D015850:Interleukin-6 / Q000097:blood / Q000276:immunology; D007962:Leukocytes / Q000276:immunology; D008875:Middle Aged; D011126:Polypropylenes / Q000009:adverse effects* / Q000276:immunology; D019919:Prosthesis Implantation / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects
D001672:Biocompatible Materials; D015850:Interleukin-6; D011126:Polypropylenes; D005340:Fibrinogen; D002097:C-Reactive Protein