Biostability, inflammatory response, and healing characteristics of a fluoropassivated polyester-knit mesh in the repair of experimental abdominal hernias

The present study was undertaken to validate the benefits of a fluoropolyme r treatment on the biostability, inflammatory response, and healing charact eristics of a polyester mesh used for hernia repair, the Fluoromesh, as com pared to a commercial monofilament-knit polypropylene mesh, Marlex, used as the control. Both were implanted for the repair of surgically induced abdo minal hernias in piglets for prescheduled durations of implantation of 4, 1 5, and 60 days. The mesh and surrounding tissue were harvested at the sacri fice for the bursting strength and inflammatory response measurements in te rms of alkaline and acid phosphatase secretion in the tissue, and for histo logical observations of the healing sequence and tissue thickness measureme nts by histomorphometric techniques. After cleaning to remove adherent tiss ue, the presence of the fluoropolymer at the surface of the mesh was detect ed using SEM and ESCA. The results demonstrated greater mechanical reinforc ement and tissue development for the Fluoromesh than for the polypropylene mesh. The healing performance of the Fluoromesh was attributed to a more in tense chronic inflammatory reaction early after implantation that stimulate d significantly greater tissue ingrowth and integration. The concentration of fluoropolymer at the surface of the mesh was masked as a result of biolo gical species adsorption. Textile analysis revealed that the Fluoromesh was dimensionally more stable in vivo than the polypropylene control mesh, whi ch demonstrated stretching in the weft direction and shrinking in the warp direction during implantation.