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01.10.2013 | Original Article | Ausgabe 10/2013

International Urogynecology Journal 10/2013

Highly purified collagen coating enhances tissue adherence and integration properties of monofilament polypropylene meshes

Zeitschrift:
International Urogynecology Journal > Ausgabe 10/2013
Autoren:
Rodrigo Teixeira Siniscalchi, Marli Melo, Paulo César Rodrigues Palma, Inácio Maria Dal Fabbro, Benedicto de Campos Vidal, Cassio Luiz Zanettini Riccetto

Abstract

Introduction and hypothesis

Complications related to tissue integration of polypropylene implants used in the treatment of pelvic organ prolapse are relatively prevalent. Collagen, a biocompatible, less immunogenic material with modulating properties on the inflammatory process, may improve polypropylene integration. The objective was to study biomechanical and histological effects of monofilament polypropylene mesh coated with purified collagen gel.

Methods

Forty rats were implanted with two fragments of polypropylene mesh in their abdominal walls (one on each side of the linea alba). One of the fragments had a collagen gel coating (group I) while the other one did not (group II). The animals were euthanized at 7, 14, 90, and 180 days after implantation and their abdominal walls were excised for analysis.

Results

The biomechanical study showed that mesh adherence to neighboring tissue increased significantly in group II (p < 0.05). Acute (p < 0.001) and chronic (p = 0.004) inflammatory responses as well as granulation tissue formation (p = 0.001) were less intense in group II at 7 and 14 days. Granulomatous inflammation and foreign body reaction was less significant at 7 days in group II (p = 0.029 and p < 0.001). The birefringence analysis showed higher mean brightness density in the late phase of implantation in group II meshes (p = 0.000).

Conclusion

Polypropylene mesh coated with purified collagen gel increases adherence to tissue, promotes a less intense and lasting inflammatory response and triggers a greater organization and packing arrangement of collagen fibers in the late phase of implantation.

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