Top

Langenbeck's Archives of Surgery

Published in:

01-05-2008 | Original Article

Prolene–Monocryl-composite meshes do not increase microvascular Staphylococcus aureus adherence and do not sensitize for leukocytic inflammation

Authors: Jonas Roller, Matthias W. Laschke, Shneh Sethi, Mathias Herrmann, Michael D. Menger

Published in: Langenbeck's Archives of Surgery | Issue 3/2008

Abstract

Background and aims

Mesh implantation for hernia repair bears the risk of bacterial mesh infection. In this study, we analyzed whether this complication is supported by an increased interaction of bacteria and leukocytes with the microvascular endothelium at the implantation site.

Materials and methods

Ultrapro meshes were implanted into the dorsal skinfold chamber of Syrian golden hamsters. After 12 days, fluorescein isothiocyanate (FITC)-labeled staphylococci were injected in the animals. Subsequently, we analyzed bacterial adherence, leukocyte–endothelial cell interaction, and microhemodynamics in venules of the mesh border zone and of distant control tissue under baseline conditions and during TNF-α-induced inflammation using intravital fluorescence microscopy. The results were compared to animals which did not receive any bacteria.

Results

Under baseline conditions, leukocyte–endothelial cell interaction and bacterial adherence were not affected by the implanted biomaterial. TNF-α-induced inflammation significantly increased numbers of adherent leukocytes and bacteria in venules located in direct vicinity to the mesh however without any differences to control tissue. Comparable results were found for the leukocyte–endothelial cell interaction when animals were not exposed to bacteria.

Conclusion

Implanted Ultrapro meshes do neither increase microvascular Staphylococcus aureus adherence nor sensitize for leukocytic inflammation. Thus, we suggest that a mesh-induced increase of bacterial adherence in vessels of the implantation site cannot be considered as a primary cause for the development of mesh infection.

Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83:1045–1051PubMedCrossRef

Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W, Veterans Affairs Cooperative Studies Program 456 Investigators (2004) (1819–1827) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819-1827PubMedCrossRef

Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398PubMedCrossRef

Collaboration EH (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:854–859PubMedCrossRef

Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583PubMed

Nienhuijs S, Staal E, Strobbe L, Rosman C, Groenewoud H, Bleichrodt R (2007) Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg 194:394–400PubMedCrossRef

Cobb WS, Harris JB, Lokey JS, McGill ES, Klove KL (2003) Incisional herniorrhaphy with intraperitoneal composite mesh: a report of 95 cases. Am Surg 69:784–787PubMed

Holzheimer RG (2007) Low recurrence rate in hernia repair—results in 300 patients with open mesh repair of primary inguinal hernia. Eur J Med Res 12:1–5PubMed

Jezupovs A, Mihelsons M (2006) The analysis of infection after polypropylene mesh repair of abdominal wall hernia. World J Surg 30:2270–2278PubMedCrossRef

10.

Yerdel MA, Akin EB, Dolalan S, Turkcapar AG, Pehlivan M, Gecim IE, Kuterdem E (2001) Effect of single-dose prophylactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polypropylene mesh: the randomized, double-blind, prospective trial. Ann Surg 233:26–33PubMedCrossRef

11.

Ríos A, Rodríguez JM, Munitiz V, Alcaraz P, Pérez Flores D, Parrilla P (2001) Antibiotic prophylaxis in incisional hernia repair using a prosthesis. Hernia 5:148–152PubMedCrossRef

12.

Mann DV, Prout J, Havranek E, Gould S, Darzi A (1998) Late-onset deep prosthetic infection following mesh repair of inguinal hernia. Am J Surg 176:12–14PubMedCrossRef

13.

Delikoukos S, Tzovaras G, Liakou P, Mantzos F, Hatzitheofilou C (2007) Late-onset deep mesh infection after inguinal hernia repair. Hernia 11:15–17PubMedCrossRef

14.

Engelsman AF, van der Mei HC, Ploeg RJ, Busscher HJ (2007) The phenomenon of infection with abdominal wall reconstruction. Biomaterials 28:2314–2327PubMedCrossRef

15.

Bellón JM, Bujan J, Contreras L, Hernando A, Jurado F (1994) Macrophage response to experimental implantation of polypropylene prostheses. Eur Surg Res 26:46–53PubMedCrossRef

16.

Foschi D, Corsi F, Cellerino P, Trabucchi A, Trabucchi E (1998) Late rejection of the mesh after laparoscopic hernia repair. Surg Endosc 12:455–457PubMedCrossRef

17.

Homer-Vanniasinkam S (2007) Surgical site and vascular infections: treatment and prophylaxis. Int J Infect Dis 11(Suppl 1):S17–S22PubMedCrossRef

18.

Falagas ME, Kasiakou SK (2005) Mesh-related infections after hernia repair surgery. Clin Microbiol Infect 11:3–8PubMedCrossRef

19.

Laschke MW, Kerdudou S, Herrmann M, Menger MD (2005) Intravital fluorescence microscopy: a novel tool for the study of the interaction of Staphylococcus aureus with the microvascular endothelium in vivo. J Infect Dis 191:435–443PubMedCrossRef

20.

Kerdudou S, Laschke MW, Sinha B, Preissner KT, Menger MD, Herrmann M (2006) Fibronectin binding proteins contribute to the adherence of Staphylococcus aureus to intact endothelium in vivo. Thromb Haemost 96:183–189PubMed

21.

Endrich B, Asaishi K, Götz A, Messmer K (1980) Technical report—a new chamber technique for microvascular studies in unanesthetized hamsters. Res Exp Med (Berl) 177:125–134CrossRef

22.

Menger MD, Laschke MW, Vollmar B (2002) Viewing the microcirculation through the window: some twenty years experience with the hamster dorsal skinfold chamber. Eur Surg Res 34:83–91PubMedCrossRef

23.

Sinha B, François PP, Nüsse O, Foti M, Hartford OM, Vaudaux P, Foster TJ, Lew DP, Herrmann M, Krause KH (1999) Fibronectin-binding protein acts as Staphylococcus aureus invasin via fibronectin bridging to integrin alpha5beta1. Cell Microbiol 1:101–117PubMedCrossRef

24.

Sinha B, Francois P, Que YA, Hussain M, Heilmann C, Moreillon P, Lew D, Krause KH, Peters G, Herrmann M (2000) Heterologously expressed Staphylococcus aureus fibronectin-binding proteins are sufficient for invasion of host cells. Infect Immun 68:6871–6878PubMedCrossRef

25.

Rücker M, Laschke MW, Junker D, Carvalho C, Schramm A, Mülhaupt R, Gellrich NC, Menger MD (2006) Angiogenic and inflammatory response to biodegradable scaffolds in dorsal skinfold chambers of mice. Biomaterials 27:5027–5038PubMedCrossRef

26.

Laschke MW, Witt K, Pohlemann T, Menger MD (2007) Injectable nanocrystalline hydroxyapatite paste for bone substitution: in vivo analysis of biocompatibility and vascularization. J Biomed Mater Res B Appl Biomater 82:494–505PubMed

27.

Baker M, Wayland H (1974) On-line volume flow rate and velocity profile measurement for blood in microvessels. Microvasc Res 7:131–143PubMedCrossRef

28.

Laschke MW, Häufel JM, Thorlacius H, Menger MD (2005) New experimental approach to study host tissue response to surgical mesh materials in vivo. J Biomed Mater Res A 74:696–704PubMed

29.

Taylor SG, O'Dwyer PJ (1999) Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg 86:562–565PubMedCrossRef

30.

Ainscow DA, Denham RA (1984) The risk of haematogenous infection in total joint replacements. J Bone Jt Surg Br 66:580–582

31.

Harrell AG, Novitsky YW, Kercher KW, Foster M, Burns JM, Kuwada TS, Heniford BT (2006) In vitro infectability of prosthetic mesh by methicillin-resistant Staphylococcus aureus. Hernia 10:120–124PubMedCrossRef

32.

Papenfuss HD, Gross JF, Intaglietta M, Treese FA (1979) A transparent access chamber for the rat dorsal skin fold. Microvasc Res 18:311–318PubMedCrossRef

33.

Lehr HA, Leunig M, Menger MD, Nolte D, Messmer K (1993) Dorsal skinfold chamber technique for intravital microscopy in nude mice. Am J Pathol 143:1055–1062PubMed

34.

Kraft CN, Hansis M, Arens S, Menger MD, Vollmar B (2000) Striated muscle microvascular response to silver implants: a comparative in vivo study with titanium and stainless steel. J Biomed Mater Res 49:192–199PubMedCrossRef

35.

Kraft CN, Burian B, Perlick L, Wimmer MA, Wallny T, Schmitt O, Diedrich O (2001) Impact of a nickel-reduced stainless steel implant on striated muscle microcirculation: a comparative in vivo study. J Biomed Mater Res 57:404–412PubMedCrossRef

36.

Kraft CN, Burian B, Diedrich O, Gessmann J, Wimmer MA, Pennekamp PH (2005) Microvascular response of striated muscle to common arthroplasty-alloys: a comparative in vivo study with CoCrMo, Ti-6Al-4V, and Ti-6Al-7Nb. J Biomed Mater Res A 75:31–40PubMed

37.

Druecke D, Langer S, Lamme E, Pieper J, Ugarkovic M, Steinau HU, Homann HH (2004) Neovascularization of poly(ether ester) block-copolymer scaffolds in vivo: long-term investigations using intravital fluorescent microscopy. J Biomed Mater Res A 68:10–18PubMedCrossRef

38.

Laschke MW, Rücker M, Jensen G, Carvalho C, Mülhaupt R, Gellrich NC, Menger MD (2007) Incorporation of growth factor containing matrigel promotes vascularization of porous PLGA scaffolds. J Biomed Mater Res A, in press. DOI 10.1002/jbm.a.31503

39.

Klosterhalfen B, Hermanns B, Rosch R, Junge K (2003) Biological response to mesh. Eur Surg 35:16–20CrossRef

40.

Tang L, Jennings TA, Eaton JW (1998) Mast cells mediate acute inflammatory responses to implanted biomaterials. Proc Natl Acad Sci U S A 95:8841–8846PubMedCrossRef

41.

Rosch R, Junge K, Schachtrupp A, Klinge U, Klosterhalfen B, Schumpelick V (2003) Mesh implants in hernia repair—inflammatory cell response in a rat model. Eur Surg Res 35:161–166PubMedCrossRef

42.

Möhle R, Green D, Moore MAS, Nachman RL, Rafii S (1997) Constitutive production and thrombin-induced release of vascular endothelial growth factor by human megakaryocytes and platelets. Proc Natl Acad Sci U S A 94:663–668PubMedCrossRef

43.

Shaw JP, Chuang N, Yee H, Shamamian P (2003) Polymorphonuclear neutrophils promote rFGF-2-induced angiogenesis in vivo. J Surg Res 109:37–42PubMedCrossRef

44.

Hoffmann JN, Vollmar B, Laschke MW, Inthorn D, Fertmann J, Schildberg FW, Menger MD (2004) Microhemodynamic and cellular mechanisms of activated protein C action during endotoxemia. Crit Care Med 32:1011–1017PubMedCrossRef

45.

Copeland S, Warren HS, Lowry SF, Calvano SE, Remick D, Inflammation and the Host Response to Injury Investigators (2005) Acute inflammatory response to endotoxin in mice and humans. Clin Diagn Lab Immunol 12:60–67PubMedCrossRef

46.

Malmros C, Holst E, Hansson L, Mårtensson L, Thörne J (1994) Dynamic accumulation of neutrophils in lungs and visceral organs during early abdominal sepsis in the pig. World J Surg 18:811–816PubMedCrossRef

47.

Bestebroer J, Poppelier MJ, Ulfman LH, Lenting PJ, Denis CV, van Kessel KP, van Strijp JA, de Haas CJ (2007) Staphylococcal superantigen-like 5 binds PSGL-1 and inhibits P-selectin-mediated neutrophil rolling. Blood 109:2936–2943PubMed

48.

Vallien G, Langley R, Jennings S, Specian R, Granger DN (2000) Expression of endothelial cell adhesion molecules in neovascularized tissue. Microcirculation 7:249–258PubMedCrossRef

Title: Prolene–Monocryl-composite meshes do not increase microvascular Staphylococcus aureus adherence and do not sensitize for leukocytic inflammation
Authors: Jonas Roller
Matthias W. Laschke
Shneh Sethi
Mathias Herrmann
Michael D. Menger
Publication date: 01-05-2008
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 3/2008
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0295-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prolene–Monocryl-composite meshes do not increase microvascular Staphylococcus aureus adherence and do not sensitize for leukocytic inflammation

Abstract

Background and aims

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and aims

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2008

Use of Erythropoietin as adjuvant therapy in nerve reconstruction

The effects of contrast agent and intraductal pressure changes on the development of pancreatitis in an ERCP model in rats

Surgery for sporadic primary hyperparathyroidism: controversies and evidence-based approach

Synergistic effect of erythropoietin but not G-CSF in combination with curcumin on impaired liver regeneration in rats

PIK3CA, KRAS, and BRAF mutations in intraductal papillary mucinous neoplasm/carcinoma (IPMN/C) of the pancreas

3rd Biennial Congress of the European Society of Endocrine Surgeons, Barcelona, 24–26 April 2008