title: Use of an experimental model to evaluate infection resistance of meshes in abdominal wall surgery.
abstract: Staphylococcal species are the most common organisms causing prosthetic mesh infections, however, infections due to rapidly growing mycobacteria are increasing. This study evaluates the resistance of biomaterial for abdominal wall prostheses against the development of postoperative infection in a rat model.
  
  
  
  In 75 rats, we intramuscularly implanted three different types of prostheses: (1) low-density polypropylene monofilament mesh (PMM), (2) high-density PMM, and (3) a composite prosthesis composed of low-density PMM and a nonporous hydrophilic film. Meshes were inoculated with a suspension containing 108colony-forming units of Staphylococcus aureus, Staphylococcus epidermidis, Mycobacterium fortuitum, or Mycobacterium abscessus before wound closure. Animals were sacrificed on the eighth day postoperatively for clinical evaluation, and the implants were removed for bacteriologic analyses.
  
  
  
  Prostheses infected with S aureus showed a higher bacterial viability, worse integration, and clinical outcome compared with infection by other bacteria. Composite prostheses showed a higher number of viable colonies of both M fortuitum and Staphylococcus spp., with poorer integration in host tissue. However, when the composite prosthesis was infected with M abscessus, a lower number of viable bacteria were isolated and a better integration was observed compared with infection by other bacteria.
  
  
  
  Considering M abscessus, a smaller collagen-free contact surface shows better resistance to infection, however, depending on the type of bacteria, prostheses with a large surface, and covered with collagen shows reduced resistance to infection, worse integration, and worse clinical outcome.
authors.affiliation: Department of Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain; Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: ramontanoira@hotmail.com.
authors.forename: Ramón
authors.initials: R
authors.lastname: Pérez-Tanoira
authors.affiliation: Department of General Surgery, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Lévano-Linares
authors.affiliation: Department of General Surgery, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Á
authors.initials: Á
authors.lastname: Celdrán-Uriarte
authors.affiliation: Department of Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: M C
authors.initials: MC
authors.lastname: Isea-Peña
authors.affiliation: Department of General Surgery, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: M Sánchez
authors.initials: MS
authors.lastname: De Molina
authors.affiliation: Department of General Surgery, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: García-Vasquez
authors.affiliation: Department of Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Esteban-Moreno
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000818:Animals; D001672:Biocompatible Materials; D003094:Collagen; D059685:Herniorrhaphy / Q000295:instrumentation*; D009165:Mycobacterium Infections, Nontuberculous / Q000209:etiology / Q000517:prevention & control*; D019907:Mycobacterium fortuitum / Q000254:growth & development; D011126:Polypropylenes; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D013203:Staphylococcal Infections / Q000209:etiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000254:growth & development; D013212:Staphylococcus epidermidis / Q000254:growth & development; D013526:Surgical Mesh / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D001672:Biocompatible Materials; D011126:Polypropylenes; D003094:Collagen
keywords: Abdominal infection; Biofilm; Prosthesis; Rapidly growing mycobacteria; Rat model; Surgical site infection