Page 250 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 12
Abstract
Background
The use of meshes for abdominal hernia surgery in a contaminated environment is compromised due to a high risk of complications. Little is known about di erences in the foreign body reaction between materials in contaminated environments. Therefore we compared the presence of macrophages and their attractors after implantation of di erent meshes in a contaminated environment in vivo.
Methods
28 and 90 days after implantation, biopsies of the abdominal wall with implanted meshes (Parietene®, Parietene Composite®, C-Qur®, Sepramesh®, Dualmesh® and Omyramesh®) were harvested from a peritonitis rat model. Biopsies were analysed with immunohistochemistry for macrophage markers CD68, iNOS, and CD206, and for T-cells with CD3. Toluidine-staining was used for mast cells.
Results
More CD3- and CD68-positive cells were found in samples with meshes than in the control group without a mesh. After 90 days, Parietene Composite® and Sepramesh® were surrounded by more iNOS-positive cells than the control group. C-Qur® and Dualmesh® were surrounded by more CD206-positive cells than the control group at day 28. The M1/M2 ratio was low for all meshes.
Conclusions
Mesh-speci c cellular responses are evident in a contaminated environment and therefore these data can help the surgeon to select suitable meshes for implantation.
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