Infection susceptibility of crosslinked and non-crosslinked biological meshes in an experimental contaminated environment

Abstract

Background: This experimental study investigates infectious complications and functional outcome of biological meshes in a contaminated environment.

Methods: In 90 rats peritonitis was induced, and after 24 hours, a biological mesh was implanted intraperitoneally including 2 non-crosslinked mesh groups (Strattice and Surgisis) and 2 crosslinked mesh groups (CollaMendFM and Permacol). Sacrifice was after 90 and 180 days.

Results: More mesh infections occurred in crosslinked meshes compared with non-crosslinked meshes (70% vs 4%; P < .001). Mesh infection was the highest in crosslinked CollaMendFM (81.2%) and lowest in non-crosslinked Strattice groups (0%). Incorporation into the abdominal wall was poor in all meshes (0% to 39%). After 180 days no residue of non-crosslinked Surgisis mesh was found. After 180 days, shrinkage was .8% in crosslinked Permacol and 20% in Strattice groups. Strattice showed the least adhesion formation (median 5%).

Conclusions: Infection rate of biological meshes in a contaminated field was the highest in crosslinked meshes. All biological meshes showed poor incorporation, which makes long-term abdominal wall repair questionable.

Keywords: Adhesion formation; Biological mesh; Complications; Hernia; Incorporation; Infection.