Large-pore PDS mesh compared to small-pore PG mesh.
BACKGROUND
Currently, absorbable meshes are used as temporary closure in case of laparostoma. Unfortunately the multifilament polyglycolic acid (PG) meshes with small pores reveal little elasticity acting rather as a fluid barrier than permitting drainage of intra-abdominal fluids. Therefore, a new mesh was constructed of absorbable polydioxanon monofilaments (PDS) with increased porosity and longer degradation time.


METHODS
For evaluation of the tissue response the new PDS mesh was implanted as abdominal wall replacement in each five rats for 7, 21, or 90 days, respectively, and compared to a PG mesh. Histological analysis included HE staining with measurement of the size of the granuloma and immunoshistochemistry for TUNEL, Ki67, TNF-R2, MMP-2, YB1, FVIII, gas6, AXL. Parameters for neovascularization and nerve ingrowth were analyzed.


RESULTS
The inflammatory and fibrotic tissue reaction is attenuated with PDS in comparison to PG, e.g., the size of the granuloma was smaller with less cell turnover, and less remodeling as represented by, e.g., reduction of apoptosis, expression of MMP-2, or TNF-R2. The number of ingrowing nerves and vessels explored via AXL, gas6, and factor VIII was increased in the PDS mesh.


CONCLUSIONS
The results from the present investigation showed that a mesh can be constructed of monofilament PDS that induce significant less inflammatory and fibrotic reaction, however permits fluid drainage and preserves elasticity.
Otto
J
J
Department of Surgery, University Clinic RWTH Aachen, Pauwelsstrasse, Aachen, Germany. jeotto@ukaachen.d
Binnebösel
M
M
Pietsch
S
S
Anurov
M
M
Titkova
S
S
Ottinger
A P
AP
Jansen
M
M
Rosch
R
R
Kämmer
D
D
Klinge
U
U
D000818:Animals; D001672:Biocompatible Materials; D024042:Collagen Type I / Q000378:metabolism; D024061:Collagen Type III / Q000378:metabolism; D015745:Granuloma, Foreign-Body / Q000473:pathology; D008297:Male; D023421:Models, Animal; D016687:Polydioxanone; D011100:Polyglycolic Acid; D051381:Rats; D017207:Rats, Sprague-Dawley; D013526:Surgical Mesh; D014945:Wound Healing / Q000502:physiology*
D001672:Biocompatible Materials; D024042:Collagen Type I; D024061:Collagen Type III; D011100:Polyglycolic Acid; D016687:Polydioxanone