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01-01-2011 | Original Article

Correlation between shrinkage and infection of implanted synthetic meshes using an animal model of mesh infection

Authors: Laurent Mamy, Vincent Letouzey, Jean-Philippe Lavigne, Xavier Garric, Jean Gondry, Pierre Mares, Renaud de Tayrac

Published in: International Urogynecology Journal | Issue 1/2011

Abstract

Introduction and hypothesis

The aim of this study was to evaluate a link between mesh infection and shrinkage.

Methods

Twenty-eight Wistar rats were implanted with synthetic meshes that were either non-absorbable (polypropylene (PP), n = 14) or absorbable (poly (d,l-lactic acid) (PLA94), n = 14). A validated animal incisionnal abdominal hernia model of mesh infection was used. Fourteen meshes (n = 7 PLA94 and n = 7 PP meshes) were infected intraoperatively with 10e6 CFU Escherichia coli, and compared with 14 non-infected meshes (n = 7 PLA94 and n = 7 PP meshes) (control groups). Explantations were performed on day 30. Shrinkage was evaluated by a reproducible numerical analysis of mesh area. Infection and histological study were evaluated on day 30.

Results

Non-infected meshes were less shrunk than infected meshes for both non-absorbable (5.0 ± 1.7% versus 21.6 ± 6.1%, p < 0.05) and absorbable meshes (2.4 ± 0.9% versus 11.0 ± 2.5%, p < 0.05).

Conclusion

This study highlights a link between infection and shrinkage in the model used.

Collinet P, Belot F, Debodinance P, Ha Duc E, Lucot JP, Cosson M (2006) Transvaginal mesh technique for pelvic organ prolapse repair: mesh exposure management and risk factors. Int Urogynecol J Pelvic Floor Dysfunct 17:315–320CrossRefPubMed

De Ridder D (2008) Should we use meshes in the management of vaginal prolapse? Curr Opin Urol 18:377–382CrossRefPubMed

Bellon JM, Bujan J, Contreras L, Hernando A (1995) Integration of biomaterials implanted into abdominal wall: process of scar formation and macrophage response. Biomaterials 16:381–387CrossRefPubMed

Birch C, Fynes MM (2002) The role of synthetic and biological prostheses in reconstructive pelvic floor surgery. Curr Opin Obstet Gynecol 14:527–535CrossRefPubMed

Cosson M (2004) Risk of infection and prostheses: time out or a red flag? J Gynécol Obstét Biol Reprod 33:559–560

Dougherty SH (1988) Pathobiology of infection in prosthetic devices. Rev Infect Dis 10:1102–1117PubMed

An YH, Friedman RJ (1998) Concise review of mechanisms of bacterial adhesion to biomaterial surfaces. J Biomed Mater Res 43:338–348CrossRefPubMed

Marshall K (1985) Mechanisms of bacterial adhesions at solid-water interfaces. In: Savage D, Fletcher M (eds) Bacterial adhesion. Mechanisms and physiological significance. Plenum, New York

Huang KH, Kung FT, Liang HM, Chang SY (2005) Management of polypropylene mesh erosion after intravaginal midurethral sling operation for female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 16:437–440CrossRefPubMed

10.

de Tayrac R, Oliva-Lauraire MC, Guiraud I, Henry L, Vert M, Mares P (2007) Long-lasting bioresorbable poly(lactic acid) 94 mesh: a new approach for soft tissue reinforcement based on an experimental pilot study. Int Urogynecol J Pelvic Floor Dysfunct 18:1007–1014CrossRefPubMed

11.

de Tayrac R, Chentouf S, Garreau H, Braud C, Guiraud I, Boudeville P, Vert M (2008) In vitro degradation and in vivo biocompatibility of poly(lactic acid) 94 mesh for soft tissue reinforcement in vaginal surgery. J Biomed Mater Res B Appl Biomater 85:529–536PubMed

12.

Alponat A, Lakshminarasappa SR, Yavuz N, Goh PMY (1997) Prevention of adhesions by Seprefilm, an absorbable adhesion barrier: an incisional hernia model in rats. Am Surg 63:818–819PubMed

13.

Zheng F, Lin Y, Verbeken E et al (2004) Host response after reconstruction of abdominal wall defects with porcine dermal collagen in a rat model. Am J Obstet Gynecol 191:1961–1970CrossRefPubMed

14.

Mathé ML, Lavigne JP, Oliva-Lauraire MC, Guiraud I, Marès P, de Tayrac R (2007) Comparison of different biomaterials for vaginal surgery using an in vivo model of meshes infection in rats. Gynécol Obstét Fertil 35:398–405CrossRefPubMed

15.

Hiltunen R, Nieminen K, Takala T et al (2007) Low weight polypropylene mesh for anterior vaginal wall prolapse: a randomized controlled trial. Obstet Gynecol 110:455–462CrossRefPubMed

16.

Nguyen JN, Burchette RJ (2008) Outcome after anterior vaginal prolapse repair: a randomized controlled trial. Obstet Gynecol 111:891–898CrossRefPubMed

17.

Sivaslioglu AA, Unlubilgin E, Dolen I (2008) A randomized comparison of polypropylene mesh surgery with site specific surgery in the treatment of cystocele. Int Urogynecol J Pelvic Floor Dysfunct 19:467–471CrossRefPubMed

18.

Weyhe D, Hoffmann P, Belyaev O, Mros K, Muller C, Uhl W, Schmitz F (2007) The role of TGF-beta1 as a determinant of foreign body reaction to alloplastic materials in rat fibroblast cultures: comparison of different commercially available polypropylene meshes for hernia repair. Regul Pept 138(1):10–14, Epub 2006 Sep 12CrossRefPubMed

19.

Sergent F, Desilles N, Lacoume Y, Bunel C, Marie JP, Marpeau L (2009) Experimental biomechanical evaluation of polypropylene prostheses used in pelvic organ prolapse surgery. Int Urogynecol J 20:597–604CrossRef

20.

Judlin P (2002) Infections in gynecology. Masson, Paris, pp p6–p7

21.

Gristina AG (1987) Biomaterial-centered infection: microbial adhesion versus tissue integration. Science 237:1588–1595CrossRefPubMed

22.

Klinge U, Junge K, Spellerberg B, Piroth C, Klosterhalfen B, Schumpelick V (2002) Do multifilament alloplastic meshes increase the infection rate? Analysis of the polymeric surface, the bacteria adherence, and the in vivo consequences in a rat model. J Biomed Mater Res 63:765–771CrossRefPubMed

Title: Correlation between shrinkage and infection of implanted synthetic meshes using an animal model of mesh infection
Authors: Laurent Mamy
Vincent Letouzey
Jean-Philippe Lavigne
Xavier Garric
Jean Gondry
Pierre Mares
Renaud de Tayrac
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 1/2011
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-010-1245-7

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Correlation between shrinkage and infection of implanted synthetic meshes using an animal model of mesh infection

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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