[Immunohistochemical considerations in local inflammatory response induced by prosthetic materials].
BACKGROUND
Even they are considered inert and biocompatible, prosthetic materials induce a local inflammatory response with the host despite of their composition and structure. This reaction is responsible for most of the long-term complications of the prosthetic repair of abdominal wall defects. Unfortunately, most of the published studies are the results of animal experiments. Our study analyses the prosthetic materials extruded from humans for various reasons.


METHODS
15 prosthetic samples extruded from human patients for various reasons were analyzed. This were prepared with standard colorations (eosin - hematoxilin), for collagen (rethiculyn, Syrius red) and immunohistochemical in order to count inflammatory cells, fibroblasts, collagen fibers, blood vessels.


RESULTS
10 polypropilene (Prolene) and 5 polyester (Mersilene) samples extruded from 11 male patients and 5 female patients with the age between 36 and 73 years old (average 57.46 +/- 9.7) have been studied. Average implantation period was 15.13 +/- 14.14, larger for the Mersilene samples (p = 0.0149). Inflammatory cells, connective tissue, fibroblasts and the number of blood vessels were significantly higher for Prolene samples (p < 0.05).


CONCLUSIONS
The inflammatory response of the host to the prosthetic material persists years after the repair and is mainly dependent by the textile properties of the mesh. Polyester materials conduct to a minimal inflammatory response with lower levels of collagen deposition. The resulted scar is more supple and does not interfere with the mobility of the abdominal wall.
Oprea
V
V
Secţia Chirurgie, Spitalul Militar de Urgenţă "Constantin Papilian" Cluj-Napoca. opreacv@yahoo.com
Gavrilaş
F
F
Ghiţuică
A
A
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000009:adverse effects; D005260:Female; D059685:Herniorrhaphy; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates / Q000009:adverse effects*; D011126:Polypropylenes / Q000009:adverse effects*; D019736:Prostheses and Implants / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D014945:Wound Healing
D001672:Biocompatible Materials; D011093:Polyethylene Terephthalates; D011126:Polypropylenes; C025539:Lavsan