MORPHOLOGICAL CORRELATION OF THE FUNCTION AL MECHANICS OF THE ABDOMINAL-WALL AFTER MESH IMPLANTATION

Modern surgical hernia repair depends increasingly on synthetic meshes for reconstruction of the abdominal wall. Despite the undisputed adva ntages of the synthetic meshes currently available, reports of late co mplications after implantation are accumulating. It is essential that the synthetic meshes be improved, but this makes a standardized animal model necessary for evaluation of their biocompatibility on both func tional and morphological levels. In the present study, commercially av ailable polypropylene and polyester meshes were implanted in a rat mod el, and detailed morphological and morphometric analysis were carried out. Correlations between the morphological and morphometric data and the function of the artificial abdominal wall were then sought. In sum mary, the data show that the mesh constructions currently available ar e oversized and definitely restrict the function of the artificial abd ominal wall. The degree of inflammation and fibrosis, the pattern of f ibrosis, and the composition of the extracellular matrix exert decisiv e influences on the function. Fibrosis and inflammation are caused les s by the material itself, however, than by its density, the way it is processed, and its surface. Future, that is to say second-generated, m esh constructions should be designed with the aims of reducing the amo unt of material used and finding material-specific processing methods in mind, to improve the functionally and morphologically defined bioco mpatibility.