Experimental study on synthetic and biological mesh implantation in a contaminated environment

Br J Surg. 2012 Dec;99(12):1734-41. doi: 10.1002/bjs.8954.


Background: Implantation of meshes in a contaminated environment can be complicated by mesh infection and adhesion formation.

Methods: The caecal ligation and puncture model was used to induce peritonitis in 144 rats. Seven commercially available meshes were implanted intraperitoneally: six non-absorbable meshes, of which three had an absorbable coating, and one biological mesh. Mesh infection, intra-abdominal abscess formation, adhesion formation, incorporation and shrinkage were evaluated after 28 and 90 days. Histological examination with haematoxylin and eosin and picrosirius red staining was performed.

Results: No mesh infections occurred in Sepramesh(®) , Omyramesh(®) and Strattice(®) . One mesh infection occurred in Parietene(®) and Parietene Composite(®) . Significantly more mesh infections were found in C-Qur(®) (15 of 16; P ≤ 0·006) and Dualmesh(®) (7 of 15; P ≤ 0·035). Sepramesh(®) showed a significant increase in adhesion coverage from 12·5 per cent at 28 days to 60·0 per cent at 90 days (P = 0·010). At 90 days there was no significant difference between median adhesion coverage of Parietene Composite(®) (35·0 per cent), Omyramesh(®) (42·5 per cent), Sepramesh(®) (60·0 per cent) and Parietene(®) (72·5 per cent). After 90 days the adhesion coverage of Strattice(®) was 5·0 per cent, and incorporation (13·4 per cent) was significantly poorer than for other non-infected meshes (P ≤ 0·009). Dualmesh(®) showed shrinkage of 63 per cent after 90 days.

Conclusion: Parietene Composite(®) and Omyramesh(®) performed well in a contaminated environment. Strattice(®) had little adhesion formation and no mesh infection, but poor incorporation. Some synthetic meshes can be as resistant to infection as biological meshes.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Abscess / etiology
  • Abdominal Abscess / prevention & control
  • Animals
  • Equipment Contamination
  • Equipment Failure
  • Fibrosis / etiology
  • Intraabdominal Infections / etiology
  • Intraabdominal Infections / prevention & control
  • Ligation
  • Male
  • Peritonitis / etiology
  • Rats
  • Rats, Wistar
  • Surgical Mesh / standards*
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control*
  • Tissue Adhesions / etiology
  • Tissue Adhesions / prevention & control