Effect of biomaterial design criteria on the performance of surgical meshes for abdominal hernia repair: a pre-clinical evaluation in a chronic rat model

Abstract

Despite the recognized advantage of surgical meshes in abdominal hernia repair, reports of long term complications after implantation are increasing. 25 chronic hernia rats underwent incisional repair (n = 5/mesh group) with compressed poly(tetra-fluoro-ethylene) (cPTFE), expanded poly(tetra-fluoro-ethylene) (ePTFE), polypropylene (PP), poly(ethylene-terephtalate) + collagen (PET + C), and porcine intestinal submucosa (SIS). At 30 days, the extent and strength of intra-abdominal adhesions was evaluated, along with tissue-mesh integration, material shrinkage, and inflammatory response. The extent and tenacity of adhesions were reduced in PET + C and SIS, while tissue contraction was largely reduced in the presence of cPTFE. The tissue integration was not affected by composition or material construction. The host tissue response was elevated and arrested in a chronic imflammatory phase in the presence of PET + C and SIS, and resolved in the case of cPTFE. The different composition and material construction did not affect significantly the overall performance of the evaluated surgical meshes, apart from PP.