title: Evaluation of six synthetic surgical meshes implanted subcutaneously in a rat model.
abstract: The long-term efficacy and mechanical integrity of implanted materials is largely determined by early host response. Therefore, implanting materials with well-characterized tissue responses provides the greatest chance of 'one-hit' surgical successes, without repeated interventions to replace, repair or remove non-compliant biomaterials. Six synthetic meshes were implanted subcutaneously in a rat model to deduce and quantify modulations in host response, based on material fabrication variables. The materials consisted of knitting variations of polypropylene (PP), polyethyleneterephthalate (PET) and polyglycolic acid (PGA) yarns and were implanted for 2, 5, 7, 14 and 28 days before fixation and both semi- and fully quantitative histopathology. In a subcutaneous niche, material weight did not influence foreign body response. PET stimulated earlier inflammation than PP and PGA, which normalized over 28 days. Multifilament meshes recruited foreign body giant cells, which were largely absent from monofilaments. Using CD68, PGA was demonstrated to be the greatest leukocyte-activating polymer at a number of the time points analysed. This research therefore highlights that underlying polymer composition may be more over-arching in deciding the inflammatory properties of surgical meshes, based on increased macrophagic responses to PGA vs alternative base polymers of comparable weights and porosities. Copyright © 2013 John Wiley & Sons, Ltd.
authors.affiliation: Clinical Engineering (UKCTE), Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK. n.bryan@liv.ac.uk.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bryan
authors.affiliation: Covidien-Sofradim Production, Trevoux, France.
authors.forename: Helen
authors.initials: H
authors.lastname: Ashwin
authors.affiliation: Clinical Engineering (UKCTE), Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.
authors.forename: Rui
authors.initials: R
authors.lastname: Chen
authors.affiliation: Exeter Health Sciences Research Unit, Royal Devon and Exeter Hospital, Devon, UK.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Smart
authors.affiliation: Covidien-Sofradim Production, Trevoux, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Bayon
authors.affiliation: Covidien-Sofradim Production, Trevoux, France.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wohlert
authors.affiliation: Clinical Engineering (UKCTE), Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.
authors.forename: John A
authors.initials: JA
authors.lastname: Hunt
mesh_terms: D000818:Animals; D008264:Macrophages / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008422:Materials Testing; D016062:Porosity; D051381:Rats; D017208:Rats, Wistar; D013526:Surgical Mesh; D013997:Time Factors
keywords: biomaterial; host response; inflammation; polymer; soft tissue repair