Page 293 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Figure 3. Macroscopic evaluation of mesh infection with meshoma of a Permacol mesh (A, B) and formation of mesh abscess in a Permacol mesh (C).
Surface reduction
The 22 animals with infected meshes were excluded from this analysis because surface of the mesh could not be accurately measured. The CollaMendFM groups were excluded from analysis because, after excluding the animals with infected meshes, an insu cient number of animals were left to perform statistical testing. Loss of surface of Surgisis was signi cantly higher at both time points compared with Strattice and Permacol (P < 0.036). Both at 90 and 180 days, only in 2 animals a very thin residue of the Surgisis mesh could be found macroscopically. Loss of surface after 90 days was signi cantly higher in the Strattice compared with the Permacol group (median [IQR], 23% [10 to 46] vs 3% [0 to 7]; P = 0.033). In the Strattice group, loss of surface after 180 days was median 20% (IQR, 10 to 41) and median 1% (IQR, 0 to 3) for the Permacol group (P = 0.075). After grouping the sca olds by crosslinking, surface reduction of the mesh was lower in the crosslinked group (median [IQR], 2% [0 to 4]) compared with the non-crosslinked group (23% [10 to 46]; P < 0.001).
Incorporation
Overall incorporation of the biological meshes into the abdominal wall at 90 and 180 days was poor (range, 0% to 39%). At 90 days, incorporation of all meshes was median 4% (IQR, 0 to 21) and at 180 days median 0% (IQR, 0 to 11). Due to the high infection rate, the CollaMendFM mesh showed incorporation of median 0% at 90 and 180 days (IQR, 0 to 24; IQR, 0 to 17, respectively). Most Surgisis meshes could not be identi ed at 90 and 180 days, leading to an overall incorporation of 0% (IQR, 0 to 0). Strattice showed incorporation of median 14% (IQR, 10 to 21) at 90 days, decreasing to median 10% (IQR, 6 to 12) at 180 days
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Infection susceptibility of biological meshes
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