Tissue integration and tolerance to meshes used in gynecologic surgery: an experimental study.
OBJECTIVE
To evaluate the tissue integration of and tolerance to five different mesh types used in genital prolapse surgery to provide mechanical support.


METHODS
We placed five different meshes (Vicryl, Vypro, Prolene, Prolene soft, and Mersuture) on the peritoneums of 12 pigs. After 10 weeks, we used light microscopy to analyze the tissue integration of and tolerance to these meshes. We looked for inflammation, vascularization, fibroblasts, collagen fibers and the organization of connective tissue.


RESULTS
The absorbable prostheses made of polyglactin 910 (Vicryl) and the non-absorbable prostheses made of polypropylene (Prolene and Prolene soft) induced the least severe inflammatory reactions. Tissue integration was best with the polypropylene meshes, which allowed the development of a well-organized, fibrous, mature, connective tissue.


CONCLUSIONS
The tissue response to prosthetic meshes depends on the material used and its structure. This work highlights the feasibility of carrying out experimental studies to test the tolerance to and integration of biomaterials used in gynecology. Such studies need to be carried out whenever new prostheses become available to validate their use in common practice.
Boulanger
Loïc
L
Department of Gynecologic Surgery, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire de Lille, Avenue Eugène Avinée, 59037 Lille Cedex, France. loicboulanger@yahoo.fr
Boukerrou
Malik
M
Lambaudie
Eric
E
Defossez
André
A
Cosson
Michel
M
D020341:Absorbable Implants / Q000009:adverse effects; D000818:Animals; D003238:Connective Tissue / Q000254:growth & development; D005260:Female; D005549:Foreign-Body Reaction; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation*; D008422:Materials Testing; D017773:Pelvic Floor / Q000601:surgery; D010537:Peritoneum / Q000601:surgery; D010538:Peritonitis / Q000209:etiology; D011098:Polyglactin 910; D011126:Polypropylenes; D013526:Surgical Mesh / Q000009:adverse effects; D013552:Swine; D014596:Uterine Prolapse / Q000601:surgery; D014945:Wound Healing / Q000502:physiology
D011126:Polypropylenes; C510058:VyproII; D011098:Polyglactin 910