title: Comparing the host tissue response and peritoneal behavior of composite meshes used for ventral hernia repair.
abstract: BACKGROUND
  The use of a prosthetic material is the best treatment option for ventral hernia repair; one of the most frequently performed abdominal surgery procedures. This preclinical study compares the behavior of a new mesh (Parietex composite ventral patch [Ptx]) with that of two existing meshes used for ventral hernia repair.
  
  
  METHODS
  Fifty-four New Zealand White rabbits (3000 g) were used in an experimental model of umbilical hernia repair (diameter 1.5 cm). The materials tested were: Ventralex ST hernia patch (Vent) (Bard Davol Inc, Warwick, RI) (n = 18); Proceed ventral patch (Ethicon, Somerville, NJ) (PVP) (n = 18) and Ptx (Covidien, Sofradim, Trevoux, France) (n = 18). At 3, 7, 14 d, and 6 wk after implant, peritoneal behavior and adhesion formation were assessed by sequential laparoscopy. Mesh mesothelial cover was determined by scanning electron microscopy. Host tissue ingrowth (collagens I and III) and the macrophage response were assessed by immunohistochemical labeling. Animals were euthanized at 2, 6 wk, and 6 mo after surgery. Data were compared using the Mann-Whitney U test.
  
  
  RESULTS
  Adhesion formation from 3 d-6 wk was significantly greater (P < 0.05) for PVP compared with Vent or Ptx. Three encapsulated PVP implants showed "tissue-integrated" adhesions affecting the intestinal loops. All three implant types showed similar patterns of collagen l and III deposition. The PVP mesh elicited the greater macrophage response both at 2 wk and 6 mo.
  
  
  CONCLUSIONS
  Ptx and Vent showed excellent mesothelialization, which led to minimum adhesion formation. The appropriate tissue integration of Ptx in the parietal neoperitoneum is likely attributable to its deployment system.
authors.affiliation: Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: García-Moreno
authors.affiliation: Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Pérez-López
authors.affiliation: Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sotomayor
authors.affiliation: Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
authors.forename: Bárbara
authors.initials: B
authors.lastname: Pérez-Köhler
authors.affiliation: Covidien-Sofradim Production, Trévoux, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Bayon
authors.affiliation: Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Pascual
authors.affiliation: Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain. Electronic address: juanm.bellon@uah.es.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Bellón
mesh_terms: D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery; D000818:Animals; D003094:Collagen / Q000494:pharmacology*; D006554:Hernia, Umbilical / Q000473:pathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D023421:Models, Animal; D010537:Peritoneum / Q000473:pathology / Q000601:surgery* / Q000648:ultrastructure; D011091:Polyesters / Q000494:pharmacology*; D011126:Polypropylenes / Q000494:pharmacology; D019736:Prostheses and Implants; D011817:Rabbits; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control; D014945:Wound Healing
chemical_list: D011091:Polyesters; D011126:Polypropylenes; C588279:parietex; D003094:Collagen
keywords: Abdominal wall repair; Epigastric hernia; Mesh repair; Polypropylene; Umbilical hernia; Ventral hernia