title: Biomechanical and histological evaluation of abdominal wall compliance with intraperitoneal onlay mesh implants in rabbits: a comparison of six different state-of-the-art meshes.
abstract: BACKGROUND
  An ideal prosthetic mesh for incisional hernia repair should mimic the anisotropic compliance of the abdominal wall, and at lower loads should exhibit higher distensibility without impairment of safety at higher loads. This study evaluated the biomechanical properties of six meshes in a rabbit model.
  
  
  METHODS
  New Zealand white rabbits were used for this study. Two meshes of the same brand (Ethicon Physiomesh™, Bard Composix(®) L/P, Gore Dualmesh(®), Bard Sepramesh(®), Ethicon Proceed(®) or Parietex™ Composite) were implanted into each animal for assessment of intra-abdominal hernia repair, with a total of ten meshes per group. Twelve weeks after implantation, the abdominal walls with ingrown meshes were harvested and examined biomechanically with a plunger test. The mesh-tissue compliance was evaluated by the forces exerted at given displacements and also described through a simple mathematical approximation. Abdominal wall samples were collected for histopathology, cell turnover and morphometry.
  
  
  RESULTS
  No mesh-related complications were seen. The adhesion score was significantly higher in Bard Composix(®) L/P and Ethicon Proceed(®) meshes. Significant shrinkage was seen in Gore Dualmesh(®) and Parietex™ Composite meshes. Physiomesh™ exhibited the highest compliance during plunger testing, characterized by lower, more physiological reaction forces against tissue displacement than the competitor meshes. In contrast, the safety modulus was comparable in all groups. Histology showed less collagen and less foreign body reaction in the Physiomesh™ samples contributing to patient's comfort.
  
  
  CONCLUSIONS
  In terms of safety, this study showed no superiority of any single mesh. The comfort modulus however differed, being lowest in the newly developed Physiomesh™.
authors: Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, D-55099 Mainz, Germany. konerdin@uni-mainz.de
authors: M A
authors: MA
authors: Konerding
authors: P
authors: P
authors: Chantereau
authors: V
authors: V
authors: Delventhal
authors: J-L
authors: JL
authors: Holste
authors: M
authors: M
authors: Ackermann
mesh_terms: D034861:Abdominal Wall / Q000473:pathology* / Q000503:physiopathology; D000269:Adhesives / Q000737:chemistry; D000818:Animals; D001696:Biomechanical Phenomena; D004146:Dioxanes / Q000737:chemistry; D005260:Female; D059685:Herniorrhaphy / Q000295:instrumentation*; D008422:Materials Testing; D055595:Mechanical Phenomena; D010529:Peritoneal Cavity / Q000601:surgery; D016687:Polydioxanone / Q000737:chemistry; D011091:Polyesters / Q000737:chemistry; D011126:Polypropylenes / Q000737:chemistry; D016062:Porosity; D019736:Prostheses and Implants; D011817:Rabbits; D014945:Wound Healing
chemical_list: D000269:Adhesives; D004146:Dioxanes; D011091:Polyesters; D011126:Polypropylenes; D016687:Polydioxanone; C095495:glycolide E-caprolactone copolymer