Pathology of traditional surgical nets for hernia repair after long-term implantation in humans

The widespread use of alloplastic materials as the standard procedure for h ernia repair makes an evaluation of the long-term integration of these impl ants imperative. A total of 121 explanted meshes (mean implantation time 23 .2 +/- 19.7 months) of polypropylene (Atrium(R), n = 20; Marlex(R), n = 50; Prolene(R), n = 21), Polyester (Mersilene(R), n = 19) and PTFE (Gore-Tex(R ), n = 11) were analyzed in regard to the tissue and cell response within t he interface mesh-fiber/tissue. The mesh samples were investigated by light and electronmicroscopy, as well as immunohistochemistry. The morphometric results confirmed a persisting inflammatory proliferative foreign-body reac tion with increased cell turnover in the recipient tissues. This reaction i s mainly influenced by the selected mesh modification. The consequences of the arising "chronic wound" are discussed in detail, in particular with reg ard to possible malignant transformation.