%0 Journal Article
%A Eickhoff, Roman Marius
%A Kroh, Andreas
%A Eickhoff, Simon
%A Heise, Daniel
%A Helmedag, Marius Julian
%A Tolba, Rene H
%A Klinge, Uwe
%A Neumann, Ulf Peter
%A Klink, Christian Daniel
%A Lambertz, Andreas
%T A peritoneal defect covered by intraperitoneal mesh prosthesis effects an increased and distinctive foreign body reaction in a minipig model
%J Journal of biomaterials applications
%V 35
%N 6
%@ 1530-8022
%C Thousand Oaks, Calif. [u.a.]
%I Sage
%M FZJ-2020-03930
%P 732-739 
%D 2020
%Z The author(s) disclosed receipt of the following financial supportfor the research, authorship, and/or publication of thisarticle: This study was granted by the BMBF (FederalMinistry of Education and Research) (Funding number:13N12599.
%X Background: The incidence of incisional hernia is with up to 30% one of the frequent long-term complication afterlaparotomy. After establishing minimal invasive operations, the laparoscopic intraperitoneal onlay mesh technique(lap. IPOM) was first described in 1993. Little is known about the foreign body reaction of IPOM-meshes, which covereda defect of the parietal peritoneum. This is becoming more important, since IPOM procedure with peritoneal-sacresection and hernia port closing (IPOM plus) is more frequently used.Methods: In 18 female minipigs, two out of three Polyvinylidene-fluoride (PVDF) -meshes (I: standard IPOM; II: IPOMwith modified structure [bigger pores]; III: IPOM with the same structure as IPOM IIþdegradable hydrogel-coating)were placed in a laparoscopic IPOM procedure. Before mesh placement, a 2x2cm peritoneal defect was created. After30 days, animals were euthanized, adhesions were evaluated by re-laparoscopy and mesh samples were explanted forhistological and immunohistochemichal investigations.Results: All animals recovered after implantation and had no complications during the follow-up period. Analysingforeign body reaction, the IPOM II mesh had a significant smaller inner granuloma, compared to the other meshes (IPOMII: 8.4 mm1.3 vs. IPOM I 9.1 mm1.3, p<0.001). The degradable hydrogel coating does not prevent adhesionsmeasured by Diamond score (p¼0.46). A peritoneal defect covered by a standard or modified IPOM mesh was asignificant factor for increasing foreign body granuloma, the amount of CD3þ lymphocytes, CD68þ macrophages anddecrease of pore size.Conclusion: A peritoneal defect covered by IPOM prostheses leads to an increased foreign body reaction compared tointact peritoneum. Whenever feasible, a peritoneal defect should be closed accurately before placing an IPOM-mesh toavoid an excessive foreign body reaction and therefore inferior biomaterial properties of the prosthesis.
%F PUB:(DE-HGF)16
%9 Journal Article
%$ 33331198
%U <Go to ISI:>//WOS:000583370400001
%R 10.1177/0885328220963918
%U https://juser.fz-juelich.de/record/885559