Page 279 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Discussion
Macrophages in a contaminated environment
As tolerance to biomaterials in surgical areas at risk of postoperative contamination is not understood completely, surgeons are reluctant to use biomaterials in these circumstances. Biomaterials should be explored for safer use in surgical environments prone to the development of postoperative infection. Macrophages are key players in the foreign body reaction, thus in uencing the fate of biomaterials. In the present study the e ect of biomaterials on macrophage phenotypes in an experimental model of postoperative contamination in rats, and in an in vitro model of in ammation, were studied.
Implantation of the mono lament PP biomaterial in a contaminated environment in the rat in vivo(15) revealed that PP bres became surrounded by a small layer of dense tissue with many macrophages and other leucocytes. Compared with a contaminated abdominal wall without PP, which by day 28 displayed only a few in ammatory cells, the implanted PP mesh appeared to extend the postoperative in ammatory reaction. No residual bacteria were observed on the Gram staining (data not shown), in agreement with previous
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