Comparison of contracture, adhesion, tissue ingrowth, and histologic response characteristics of permanent and absorbable barrier meshes in a porcine model of laparoscopic ventral hernia repair.

Deeken, C R; Matthews, B D

PURPOSE The objective of this study was to determine the mesh contracture, adhesion, tissue ingrowth, and histologic characteristics of a novel absorbable barrier mesh (Ventrioâ„¢ ST Hernia Patch) compared to existing permanent (Ventrioâ„¢ Hernia Patch) and absorbable barrier meshes (Seprameshâ„¢ IP Composite and PROCEEDâ„¢ Surgical Mesh). METHODS Standard laparoscopic technique was utilized to bilaterally implant meshes in 20 female Yorkshire pigs (n = 5 pigs/group). Meshes were fixated to the intact peritoneum with SorbaFixâ„¢ absorbable fixation devices. Mesh contracture, adhesion coverage, and adhesion tenacity were evaluated after 4 weeks. T-Peel testing and hematoxylin and eosin (H&E) staining were utilized to assess tissue ingrowth and host response. RESULTS A significantly greater percent area contracture was demonstrated for PROCEEDâ„¢ (26.9%) compared to Ventrioâ„¢ ST (8.8%), Ventrioâ„¢ (14.5%) and Seprameshâ„¢ (9.2%). Ventrioâ„¢ ST demonstrated similar adhesion area, tenacity, and tissue ingrowth compared to all other meshes. Histological scoring revealed a comparable host inflammatory response for all meshes, with a few exceptions. A greater number of giant cells were observed in Ventrioâ„¢ ST and Seprameshâ„¢ near the multifilament polyglycolic acid (PGA) fibers; a greater number of macrophages were observed in PROCEEDâ„¢ compared to Ventrioâ„¢; and a greater number of neutrophils were observed in PROCEEDâ„¢, compared to Seprameshâ„¢ (P < 0.05). Focal areas of hemorrhage were also observed on the visceral surface of PROCEEDâ„¢. CONCLUSIONS Ventrioâ„¢ ST Hernia Patch demonstrated comparable contracture, adhesion, tissue ingrowth, and histologic characteristics compared to existing permanent and absorbable barrier meshes. Host inflammatory and fibrotic responses for all four meshes were minimal and representative of a biocompatible response.