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000885559 1001_ $$0P:(DE-HGF)0$$aEickhoff, Roman Marius$$b0$$eCorresponding author
000885559 245__ $$aA peritoneal defect covered by intraperitoneal mesh prosthesis effects an increased and distinctive foreign body reaction in a minipig model
000885559 260__ $$aThousand Oaks, Calif. [u.a.]$$bSage$$c2020
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000885559 500__ $$aThe author(s) disclosed receipt of the following financial supportfor the research, authorship, and/or publication of thisarticle: This study was granted by the BMBF (FederalMinistry of Education and Research) (Funding number:13N12599.
000885559 520__ $$aBackground: 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.
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000885559 7001_ $$0P:(DE-HGF)0$$aKroh, Andreas$$b1
000885559 7001_ $$0P:(DE-Juel1)131678$$aEickhoff, Simon$$b2
000885559 7001_ $$00000-0001-6923-0849$$aHeise, Daniel$$b3
000885559 7001_ $$00000-0002-8914-7978$$aHelmedag, Marius Julian$$b4
000885559 7001_ $$0P:(DE-HGF)0$$aTolba, Rene H$$b5
000885559 7001_ $$0P:(DE-HGF)0$$aKlinge, Uwe$$b6
000885559 7001_ $$aNeumann, Ulf Peter$$b7
000885559 7001_ $$0P:(DE-HGF)0$$aKlink, Christian Daniel$$b8
000885559 7001_ $$0P:(DE-HGF)0$$aLambertz, Andreas$$b9
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