Page 240 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 11
Figure 3. Mesh edge incorporation at 28 and 90 days’ follow-up. Values are median (interquartile range). *P < 0•050 versus Parietene Composite®, Sepramesh®, C-Qur® and Omyramesh® at 28 days; #P < 0•050 versus Parietene®, Parietene Composite®, Sepramesh® and Omyramesh® at 28 days; §P < 0•050 versus Parietene Composite® and Omyramesh® at 28 days; **P < 0•050 versus Parietene®, Parietene Composite®, Sepramesh®, C-Qur® and Omyramesh® at 90 days; ##P < 0•050 versus all other meshes at 90 days; §§P < 0•050 versusParietene®, Parietene Composite®, C-Qur® and Omyramesh® at 90 days (Mann–Whitney Utest).
Shrinkage
The shrinkage of C-Qur® could not be determined owing to the formation of large brotic pseudotumours in all but one of the meshes. The non-infected Dualmesh® showed the highest percentage loss of mesh surface, of 63% after 90 days (P ≤ 0.012 compared with other meshes). All other meshes had a median loss of mesh surface of between 0 and 10% after 28 days. Strattice showed a progressive median loss of surface from 0% at 28 days to 23% at 90 days (P = 0.003). After 90 days the purely synthetic Dualmesh®, Omyramesh® and Parietene® showed shrinkage of between 0 and 15%. Parietene Composite® and Sepramesh® did not shrink after 90 days (P ≤ 0.026 and P ≤ 0.014 respectively compared with all other meshes).
Histology
Fibrosis was observed in all mesh-surrounding tissues. This was especially pronounced for the four polypropylene based meshes and Omyramesh® (Figure 4). Dualmesh® showed a clear encapsulation of the mesh, almost
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