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01-08-2016 | Original Article

Tissue integration and inflammatory reaction in full-thickness abdominal wall repair using an innovative composite mesh

Authors: G. Pascual, S. Sotomayor, M. Rodríguez, Y. Bayon, J. M. Bellón

Published in: Hernia | Issue 4/2016

Abstract

Purpose

When composite meshes are used in abdominal wall repair, seroma formation may persist and delay the desired integration leading to recurrence. This study compares tissue integration and inflammatory response in abdominal wall repair with composites with different absorbable synthetic barriers.

Methods

Full-thickness defects created in the abdominal wall of rabbits were repaired using polypropylene prosthesis or the following composites: Physiomesh™ (Phy); Ventralight™ (Vent) and “new composite mesh” (Ncm) not yet used clinically in humans. The collected seroma was evaluated for IFN-γ/IL-4 by ELISA. Tissue integration, anti- (IL-13/TGFβ-1/IL-10/IL-4) and pro-inflammatory (TNF-α/IL-6/IFN-γ/VEGF) cytokine mRNA expression and TGFβ/VEGF immunolabeling were evaluated at 14 and 90 days post-implant.

Results

Seroma was observed in 10 of 12 Phy/Vent and 4 of 12 Ncm. Wound fluid IFN-γ showed a time-dependent significant increase in Vent and tendency to decrease in Ncm, while all composites exhibited IL-4 upward trend. Prostheses were fully infiltrated by an organized connective tissue at end time although the area had shown prior seroma. A stable mesothelium was developed, except in adhesion areas. Vent/Phy displayed a significant increase in TNF-α/IFN-γ-mRNA over time. Significant decrease in VEGF mRNA was observed in Phy/Ncm, while a significant increase of TGFβ-1 mRNA was evident in all composites over time. Ncm exhibited the highest TGFβ protein expression area at short term and the greatest percentage of VEGF positive vessels at end time.

Conclusion

Ncm could be an appropriate candidate to improve clinical outcome showing the lower development of seroma and optimal tissue integration with minimal pro-inflammatory cytokine response over time and consistent pro-wound healing cytokine expression.

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Title: Tissue integration and inflammatory reaction in full-thickness abdominal wall repair using an innovative composite mesh
Authors: G. Pascual
S. Sotomayor
M. Rodríguez
Y. Bayon
J. M. Bellón
Publication date: 01-08-2016
Publisher: Springer Paris
Published in: Hernia / Issue 4/2016
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-015-1383-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Tissue integration and inflammatory reaction in full-thickness abdominal wall repair using an innovative composite mesh

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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