title: A preclinical evaluation of alternative synthetic biomaterials for fascial defect repair using a rat abdominal hernia model.
abstract: BACKGROUND
  Fascial defects are a common problem in the abdominal wall and in the vagina leading to hernia or pelvic organ prolapse that requires mesh enhancement to reduce operation failure. However, the long-term outcome of synthetic mesh surgery may be unsatisfactory due to post-surgical complications. We hypothesized that mesh fabricated from alternative synthetic polymers may evoke a different tissue response, and provide more appropriate mechanical properties for hernia repair. Our aim was to compare the in vivo biocompatibility of new synthetic meshes with a commercial mesh.
  
  
  METHODS
  We have fabricated 3 new warp-knitted synthetic meshes from different polymers with different tensile properties polyetheretherketone (PEEK), polyamide (PA) and a composite, gelatin coated PA (PA+G). The rat abdominal hernia model was used to implant the meshes (25 × 35 mm, n = 24/ group). After 7, 30, 60, 90 days tissues were explanted for immunohistochemical assessment of foreign body reaction and tissue integration, using CD31, CD45, CD68, alpha-SMA antibodies. The images were analysed using an image analysis software program. Biomechanical properties were uniaxially evaluated using an Instron Tensile® Tester.
  
  
  RESULTS
  This study showed that the new meshes induced complex differences in the type of foreign body reaction over the time course of implantation. The PA, and particularly the composite PA+G meshes, evoked a milder early inflammatory response, and macrophages were apparent throughout the time course. Our meshes led to better tissue integration and new collagen deposition, particularly with the PA+G meshes, as well as greater and sustained neovascularisation compared with the PP meshes.
  
  
  CONCLUSIONS
  PA, PA+G and PEEK appear to be well tolerated and are biocompatible, evoking an overlapping and different host tissue response with time that might convey mechanical variations in the healing tissue. These new meshes comprising different polymers may provide an alternative option for future treatment of fascial defects.
authors.affiliation: Monash Institute of Medical Research, Clayton, Victoria, Australia.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ulrich
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Edwards
authors.forename: Jacinta F
authors.initials: JF
authors.lastname: White
authors.forename: Tommy
authors.initials: T
authors.lastname: Supit
authors.forename: John A M
authors.initials: JA
authors.lastname: Ramshaw
authors.forename: Camden
authors.initials: C
authors.lastname: Lo
authors.forename: Anna
authors.initials: A
authors.lastname: Rosamilia
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Werkmeister
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Gargett
mesh_terms: D000199:Actins / Q000378:metabolism; D000818:Animals; D015703:Antigens, CD / Q000378:metabolism; D001577:Benzophenones; D001672:Biocompatible Materials / Q000138:chemical synthesis / Q000494:pharmacology*; D015415:Biomarkers / Q000378:metabolism; D001835:Body Weight / Q000187:drug effects; D003094:Collagen / Q000378:metabolism; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D005205:Fascia / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D000071938:Fasciotomy; D005260:Female; D005780:Gelatin / Q000737:chemistry / Q000494:pharmacology*; D046449:Hernia, Abdominal / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D007150:Immunohistochemistry; D007659:Ketones / Q000737:chemistry / Q000494:pharmacology*; D008264:Macrophages / Q000187:drug effects; D009757:Nylons / Q000737:chemistry / Q000494:pharmacology*; D011092:Polyethylene Glycols / Q000737:chemistry / Q000494:pharmacology*; D011108:Polymers; D051381:Rats; D017207:Rats, Sprague-Dawley; D013526:Surgical Mesh; D013718:Tensile Strength
chemical_list: D000199:Actins; D015703:Antigens, CD; D001577:Benzophenones; D001672:Biocompatible Materials; D015415:Biomarkers; D003094:Collagen; D005780:Gelatin; D007659:Ketones; D009757:Nylons; D011092:Polyethylene Glycols; D011108:Polymers; C498862:Acta2 protein, rat; C063834:polyetheretherketone