A scanning electron microscopical study of the two sides of polypropylene mesh (Marlex) and PTFE (Gore Tex) mesh 2 years after complete abdominal wall reconstruction. A study of 15 cases.
The use of biomaterials for the repair of abdominal wall defect is becoming common and safe. It has been 20 years since the senior author developed a method to reconstruct the very large transfixing abdominal wall defect with a combination of two biomaterials (Gore Tex) PTFE as a neo peritoneum and polypropylene superficial to this in order to give rigidity to the abdominal wall) and a superficial flap. An observation at the electron microscopy level of the two sides of the implants' surfaces was performed. At the time of a late abdominal wall surgical revision on 15 patients, the prosthesis fragments have been analyzed at the electron microscopy level. The aim of our study was to analyze the late evolution of the different sides of these prostheses. Our results showed, for the first time in vivo, that there is an impressive stability of the deep side of PTFE ultra structure after implantation, a significant difference of the two sides of PTFE at the ultrastructural level and the creation of an intermediate tissue between the two meshes. In contrast, the polypropylene invariably gave rise to adhesions and colonisation by the surrounding tissues. Findings confirmed that the structure and porosity of a biomaterial play a key role in the appearance of adhesions and their consistency.
Danino
Alain M
AM
Department of Plastic and Reconstructive Surgery and The Department of Electron Microscopy at the Saint-Louis University Hospital of Paris, Paris, France. alain.danino@chu-dijon.fr
Malka
Gabriel
G
Revol
Marc
M
Servant
Jean-Marie
JM
D034861:Abdominal Wall / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials; D018223:Dermatofibrosarcoma / Q000601:surgery; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery; D006801:Humans; D008422:Materials Testing / Q000379:methods; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery; D013526:Surgical Mesh
D001672:Biocompatible Materials; D011126:Polypropylenes; D011138:Polytetrafluoroethylene