Jürgen Zieren1, Folkert Maecker, Heiko Neuss, Jochen M Müller. 1. Department of General, Visceral, Vascular and Thoracic Surgery, Charité, Campus Mitte, Humboldt University of Berlin, Schumannstrasse 20/21, 10117 Berlin, Germany. juergen.zieren@charite.de
Abstract
BACKGROUND: Trevira (polyethylene terephthalate) has been in clinical use for more than 20 years, serving as implant material with minimal foreign body reaction for the replacement of the cruciate ligaments of the knee. An animal (pig) trial was performed to ascertain whether a Trevira mesh offers any advantages over currently employed meshes like Prolene for abdominal hernia repair. METHODS: In 12 mini-pigs 10 x 10 cm of the musculofascial abdominal layer was resected preserving the peritoneum. Subsequently, a 15 x 15 cm synthetic mesh was implanted (Prolene, Ethicon, Norderstedt, Germany, or Trevira, Telos GmbH, Marburg, Germany, in six animals each) using sublay technique. The main focus was on the extent of the chronic foreign body reaction. This was assessed by a pathologist who paid special attention to the presence of foreign body giant cells after 2 and 6 months. A further assessment was made of shrinkage of the implant as a result of foreign body reaction. RESULTS: The number of giant cells after two months was significantly higher with the Prolene implant than with the Trevira implant (Prolene 2.2+/-0.4, Trevira 0.8+/-0.2, per fixed microscopic field; P<0.05). After 6 months the number of giant cells associated with the Prolene implants rose further, while it remained relatively constant for those of Trevira (Prolene 4.6+/-1.3, Trevira 1.1+/-0.5; P<0.05). No significant difference was noted over time between the two types of implant with regard to shrinkage (2 months: Prolene 0.8+/-0.3 cm(2), Trevira 0.6+/-0.4 cm(2); 6 months: Prolene 1.3+/-0.6 cm(2), Trevira 1.1+/-0.5 cm(2)). CONCLUSION: In this animal study Trevira mesh demonstrated a high biocompatibility with a low foreign body reaction; it appears to be a promising new implant for the treatment of hernias.
BACKGROUND: Trevira (polyethylene terephthalate) has been in clinical use for more than 20 years, serving as implant material with minimal foreign body reaction for the replacement of the cruciate ligaments of the knee. An animal (pig) trial was performed to ascertain whether a Trevira mesh offers any advantages over currently employed meshes like Prolene for abdominal hernia repair. METHODS: In 12 mini-pigs 10 x 10 cm of the musculofascial abdominal layer was resected preserving the peritoneum. Subsequently, a 15 x 15 cm synthetic mesh was implanted (Prolene, Ethicon, Norderstedt, Germany, or Trevira, Telos GmbH, Marburg, Germany, in six animals each) using sublay technique. The main focus was on the extent of the chronic foreign body reaction. This was assessed by a pathologist who paid special attention to the presence of foreign body giant cells after 2 and 6 months. A further assessment was made of shrinkage of the implant as a result of foreign body reaction. RESULTS: The number of giant cells after two months was significantly higher with the Prolene implant than with the Trevira implant (Prolene 2.2+/-0.4, Trevira 0.8+/-0.2, per fixed microscopic field; P<0.05). After 6 months the number of giant cells associated with the Prolene implants rose further, while it remained relatively constant for those of Trevira (Prolene 4.6+/-1.3, Trevira 1.1+/-0.5; P<0.05). No significant difference was noted over time between the two types of implant with regard to shrinkage (2 months: Prolene 0.8+/-0.3 cm(2), Trevira 0.6+/-0.4 cm(2); 6 months: Prolene 1.3+/-0.6 cm(2), Trevira 1.1+/-0.5 cm(2)). CONCLUSION: In this animal study Trevira mesh demonstrated a high biocompatibility with a low foreign body reaction; it appears to be a promising new implant for the treatment of hernias.