Schmitz Sophia M, Helmedag Marius J, Kroh Andreas, Heise Daniel, Klinge Uwe, Lambertz Andreas, Hornef Mathias W, Neumann Ulf P, Eickhoff Roman M
Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen, Germany.
Department of Medical Microbiology, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.
Biomedicines. 2023 Jul 24;11(7):2083. doi: 10.3390/biomedicines11072083.
Synthetic mesh material is of great importance for surgical incisional hernia repair. The physical and biochemical characteristics of the mesh influence mechanical stability and the foreign body tissue reaction. The influence on bacterial infections, however, remains ill-defined. The aim of the present study was to evaluate the influence of a modified mesh structure with variation in filament linking on the occurrence of bacterial infection that is indicated by the occurrence of CD68, CD4, and CD8 cells in two different materials.
A total of 56 male Sprague Dawley rats received a surgical mesh implant in a subcutaneous abdominal position. The mesh of two different polymers (polypropylene (PP) and polyvinylidenfluoride (PVDF)) and two different structures (standard structure and bold structure with higher filament linking) were compared. During the implantation, the meshes were infected with . After 7 and 21 days, meshes were explanted, and the early and late tissue responses to infection were histologically evaluated.
Overall, the inflammatory tissue response was higher at 7 days when compared to 21 days. At 7 days, PP meshes of the standard structure (PP-S) showed the strongest inflammatory tissue response in comparison to all the other groups. At 21 days, no statistically significant difference between different meshes was detected. CD8 cytotoxic T cells showed a significant difference at 21 days but not at 7 days. PP meshes of both structures showed a higher infiltration of CD8 T cells than PVDF meshes. CD4 T helper cells differed at 7 days but not at 21 days, and PVDF meshes in a bold structure showed the highest CD4 T cell count. The number of CD68 macrophages was also significantly higher in PP meshes in a standard structure when compared to PVDF meshes at 21 days.
The inflammatory tissue response to infection appears to be highest during the early period after mesh implantation. PP meshes showed a higher inflammatory response than PVDF meshes. The mesh material appears to be more important for the risk of infection than the variation in filament linking.
合成网状材料对手术切口疝修补至关重要。网片的物理和生化特性影响机械稳定性和异物组织反应。然而，其对细菌感染的影响仍不明确。本研究的目的是评估细丝连接方式不同的改良网状结构对细菌感染发生率的影响，通过两种不同材料中CD68、CD4和CD8细胞的出现情况来表明。
总共56只雄性Sprague Dawley大鼠在腹部皮下植入手术网片。比较了两种不同聚合物（聚丙烯（PP）和聚偏二氟乙烯（PVDF））以及两种不同结构（标准结构和细丝连接更多的加粗结构）的网片。植入过程中，网片被 感染。7天和21天后，取出网片，通过组织学评估对感染的早期和晚期组织反应。
总体而言，与21天时相比，7天时炎症组织反应更高。7天时，标准结构的PP网片（PP-S）与所有其他组相比显示出最强的炎症组织反应。21天时，不同网片之间未检测到统计学上的显著差异。CD8细胞毒性T细胞在21天时显示出显著差异，但在7天时没有。两种结构的PP网片均显示出比PVDF网片更高的CD8 T细胞浸润。CD4辅助性T细胞在7天时有所不同，但在21天时没有，加粗结构的PVDF网片显示出最高的CD4 T细胞计数。与21天时的PVDF网片相比，标准结构的PP网片中CD68巨噬细胞的数量也显著更高。
网状植入物植入后的早期，对感染的炎症组织反应似乎最高。PP网片比PVDF网片显示出更高的炎症反应。网片材料似乎比细丝连接方式的变化对感染风险更重要。
