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BioMed Research International
Volume 2014, Article ID 510807, 6 pages
Research Article

Inflammatory Reaction as Determinant of Foreign Body Reaction Is an Early and Susceptible Event after Mesh Implantation

1Department of Urology, Lukas Hospital, Preussenstraße 84, 41464 Neuss, Germany
2German Centre for Assessment and Evaluation of Innovative Techniques in Medicine (DZITM), Germany
3Department of Experimental Surgery, University of Szeged, Hungary
4German Centre for Implant-Pathology, Düren, Germany
5Department of Surgery, Clemens Hospital Münster, Germany
6Department of Surgery, Universitair Ziekenhuis, Antwerpen, Belgium
7ITERA (International Tissue Engineering Research Association), Belgium

Received 24 November 2013; Revised 14 January 2014; Accepted 1 February 2014; Published 26 March 2014

Academic Editor: H. C. Van der Mei

Copyright © 2014 Holger Gerullis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To investigate and relate the ultrashort-term and long-term courses of determinants for foreign body reaction as biocompatibility predictors for meshes in an animal model. Materials and Methods. Three different meshes (TVT, UltraPro, and PVDF) were implanted in sheep. Native and plasma coated meshes were placed bilaterally: (a) interaperitoneally, (b) as fascia onlay, and (c) as muscle onlay (fascia sublay). At 5 min, 20 min, 60 min, and 120 min meshes were explanted and histochemically investigated for inflammatory infiltrate, macrophage infiltration, vessel formation, myofibroblast invasion, and connective tissue accumulation. The results were related to long-term values over 24 months. Results. Macrophage invasion reached highest extents with up to 60% in short-term and decreased within 24 months to about 30%. Inflammatory infiltrate increased within the first 2 hours, the reached levels and the different extents and ranking among the investigated meshes remained stable during long-term follow up. For myofibroblasts, connective tissue, and CD31+ cells, no activity was detected during the first 120 min. Conclusion. The local inflammatory reaction is an early and susceptible event after mesh implantation. It cannot be influenced by prior plasma coating and does not depend on the localisation of implantation.