RESUMEN
PURPOSE: The study aimed to evaluate the histologic properties and infection resistance of three different mesh materials in a rat model. METHODS: Each mesh, in both infectious (n = 96) and non-infectious groups (n = 270), was positioned both in sublay (preperitoneally) and onlay (subcutaneously) locations. Properties of the biological (Surgisis; Cook Surgical), composite, partially resorbing (Vypro II mesh; Ethicon) and non-resorbing (TiMesh; GFE Medizintechnik GmbH) mesh were evaluated and compared. Animals were killed at 7, 21 and 90 days after implantation. The following parameters were evaluated to assess the host response to the mesh material: inflammation, vascularization, fibrosis, collagen formation, Ki67, and a foreign body reaction by granuloma formation (FBG). RESULTS: Surgisis mesh produced more pronounced inflammation and cell proliferation, and less intense granuloma formation, as well as fibrosis, compared to the other two groups. When the infected materials were examined, we found signs of local infection to be more often present in Surgisis group of animals. CONCLUSIONS: In the presence of bacterial contamination, no benefits were observed in the use of the Surgisis prosthesis over the use of TiMesh and Vypro II.
Asunto(s)
Implantación de Prótesis/métodos , Infecciones Relacionadas con Prótesis/etiología , Infecciones Estafilocócicas/etiología , Mallas Quirúrgicas , Animales , Materiales Biocompatibles Revestidos/administración & dosificación , Materiales Biocompatibles Revestidos/efectos adversos , Colágeno/administración & dosificación , Colágeno/efectos adversos , Modelos Animales de Enfermedad , Fibrosis/etiología , Reacción a Cuerpo Extraño/etiología , Inflamación/etiología , Masculino , Poliglactina 910/administración & dosificación , Poliglactina 910/efectos adversos , Polipropilenos/administración & dosificación , Polipropilenos/efectos adversos , Implantación de Prótesis/efectos adversos , Infecciones Relacionadas con Prótesis/microbiología , Ratas , Ratas Wistar , Staphylococcus aureus , Mallas Quirúrgicas/efectos adversos , Titanio/administración & dosificación , Titanio/efectos adversosRESUMEN
The number of obese people is over one billion worldwide, and the trend is increasing. Frequent failure of conservative approach has been observed. Therefore, various surgical techniques, such as bariatric surgery, are accepted today as a safe and effective treatment of morbid obese condition, and are associated with low perioperative morbidity and mortality rates. The most popular and commonly performed procedures are those related to minimum complications and adequate weight loss: laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass. Since major and minor complications occur in the perioperative, early and late postoperative period, we discuss most frequent complications and importance of early recognition as well as adequate interventions.
