In vitro comparison of three different mesh constructions

Abstract

Background: Material amount and pore size have been recently discussed as probable important determinants of biocompatibility of mesh implants used in hernia repair. This study aimed to find out whether other constructional parameters affect the extent of early foreign body reaction in vitro.

Materials and methods: An NRK-49F (mixed culture of normal rat kidney cells) fibroblast culture was incubated in the presence of a 'light' microporous mesh (35 g/m(2), 0.25 mm thick), a 'heavy' polypropylene knitted mesh (95 g/m(2), 0.55 mm thick) and a polypropylene/polyglactin composite mesh (35 g/m(2), 0.5 mm thick). A mesh-free cell suspension was used as a control group. Fibroblasts' proliferation, invasion and apoptosis rates were measured by commercially available quantification tests. Levels of tumour necrosis factor-alpha, transforming growth factor-beta1, interleukin (IL)-1 beta, IL-6 and IL-10 secreted by the fibroblasts in the supernatant were dynamically measured in a time kinetics of 6-96 h.

Results: Invasion potential as well as proliferation and apoptosis rates of fibroblasts were enhanced by all meshes. The composite mesh stimulated the cell turnover with correspondingly increased levels of IL-6 and suppressed levels of transforming growth factor-beta1 significantly more than the two pure polypropylene meshes and the control group.

Conclusion: Early biological response of fibroblasts as a major component of foreign body reaction was most affected by the filament construction of the mesh combining polypropylene with multifilament, partially absorbable polyglactin fibres. Material reduction did not weaken foreign body reaction. Confirming previous findings from animal experiments and clinical observations, the described in vitro model seems to be an appropriate primary tool for studying the biological tolerance towards meshes.