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- Title
Biologic Response of Inguinal Hernia Prosthetics: A Comparative Study of Conventional Static Meshes Versus 3 D Dynamic Implants.
- Authors
Amato, Giuseppe; Romano, Giorgio; Agrusa, Antonino; Marasa, Salvatore; Cocorullo, Gianfranco; Gulotta, Gaspare; Goetze, Thorsten; Puleio, Roberto
- Abstract
Despite improvements in prosthetics and surgical techniques, the rate of complications following inguinal hernia repair remains high. Among these, discomfort and chronic pain have become a source of increasing concern among surgeons. Poor quality of tissue ingrowth, such as thin scar plates or shrinking scars-typical results with conventional static implants and plugs-may contribute to these adverse events. Recently, a new type of 3 D dynamically responsive implant was introduced to the market. This device, designed to be placed fixation-free, seems to induce ingrowth of viable and structured tissue instead of regressive fibrotic scarring. To elucidate the differences in biologic response between the conventional static meshes and this 3 D dynamically responsive implant, a histological comparison was planned. The aim of this study was to determine the quality of tissue incorporation in both types of implants excised after short, medium, and long periods post-implantation. The results showed large differences in the biologic responses between the two implant types. Histologically, the 3 D dynamic implant showed development of tissue elements more similar to natural abdominal wall structures, such as the ingrowth of loose and well-hydrated connective tissue, well-formed vascular structures, elastic fibers, and mature nerves, with negligible or absent inflammatory response. All these characteristics were completely absent in the conventional static implants, where a persistent inflammatory reaction was associated with thin, hardened, and shrunken fibrotic scar formation. Consequently, as herniation is a degenerative process, the 3 D dynamic implants, which induce regeneration of the typical groin components, seem to address its pathogenesis.
- Subjects
INGUINAL hernia; PROSTHETICS; ARTIFICIAL implants; PATHOLOGY; ABDOMINAL diseases; ARTIFICIAL organs
- Publication
Artificial Organs, 2015, Vol 39, Issue 1, pE10
- ISSN
0160-564X
- Publication type
Article
- DOI
10.1111/aor.12416