title: Comparison of contracture, adhesion, tissue ingrowth, and histologic response characteristics of permanent and absorbable barrier meshes in a porcine model of laparoscopic ventral hernia repair.
abstract: OBJECTIVE
  The objective of this study was to determine the mesh contracture, adhesion, tissue ingrowth, and histologic characteristics of a novel absorbable barrier mesh (Ventrio™ ST Hernia Patch) compared to existing permanent (Ventrio™ Hernia Patch) and absorbable barrier meshes (Sepramesh™ IP Composite and PROCEED™ Surgical Mesh).
  
  
  METHODS
  Standard laparoscopic technique was utilized to bilaterally implant meshes in 20 female Yorkshire pigs (n = 5 pigs/group). Meshes were fixated to the intact peritoneum with SorbaFix™ absorbable fixation devices. Mesh contracture, adhesion coverage, and adhesion tenacity were evaluated after 4 weeks. T-Peel testing and hematoxylin and eosin (H&E) staining were utilized to assess tissue ingrowth and host response.
  
  
  RESULTS
  A significantly greater percent area contracture was demonstrated for PROCEED™ (26.9%) compared to Ventrio™ ST (8.8%), Ventrio™ (14.5%) and Sepramesh™ (9.2%). Ventrio™ ST demonstrated similar adhesion area, tenacity, and tissue ingrowth compared to all other meshes. Histological scoring revealed a comparable host inflammatory response for all meshes, with a few exceptions. A greater number of giant cells were observed in Ventrio™ ST and Sepramesh™ near the multifilament polyglycolic acid (PGA) fibers; a greater number of macrophages were observed in PROCEED™ compared to Ventrio™; and a greater number of neutrophils were observed in PROCEED™, compared to Sepramesh™ (P < 0.05). Focal areas of hemorrhage were also observed on the visceral surface of PROCEED™.
  
  
  CONCLUSIONS
  Ventrio™ ST Hernia Patch demonstrated comparable contracture, adhesion, tissue ingrowth, and histologic characteristics compared to existing permanent and absorbable barrier meshes. Host inflammatory and fibrotic responses for all four meshes were minimal and representative of a biocompatible response.
authors: Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8109, St. Louis, MO 63110, USA. deekenc@wudosis.wustl.edu
authors: C R
authors: CR
authors: Deeken
authors: B D
authors: BD
authors: Matthews
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects*; D000704:Analysis of Variance; D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects*; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D010535:Laparoscopy; D008422:Materials Testing; D018709:Statistics, Nonparametric; D013526:Surgical Mesh / Q000009:adverse effects*; D013552:Swine; D000267:Tissue Adhesions / Q000209:etiology* / Q000473:pathology
chemical_list: D001672:Biocompatible Materials