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Title: Reconstruction of the fascia with synthetic and biologic implant materials used in urogynecology
Authors: Konstantinovic, ML ×
Pottier, C
Guelinckx, Isabelle
Spelzini, F
Verbeken, Eric
De Ridder, Dirk
Deprest, Jan #
Issue Date: Sep-2006
Publisher: Springer International
Host Document: International urogynecology journal vol:17 pages:57-57
Conference: IUGA edition:31 location:Athens, Greece date:September 2006
Abstract: Objectives: To compare inflammatory response, fibrosis process and biomechanical properties of different materials already in use or proposed for augmentation of fascial repairs for genital prolapse.
Materials and methods: We experimentally compared two porcine cross-linked dermal collagen and two synthetic polypropylene containing implants: Pelvicol™ and Pelvisoft™ (Bard, Haasrode, Belgium), the latter a modification with large longitudinal slits; Pelvitex™ (Bard) as a novel collagen-coated monofilament polypropylene implant and Vypro II® (Johnson & Johnson Medical NV, Dilbeek, Belgium), lightweight mesh which is composed of resorbable multifilament polyglactin 910 and synthetic monofilament
polypropylene. The dermal collagen matrices are believed to induce a milder inflammatory response without compromising tensile strength. Implants were used to primarily repair a full thickness abdominal wall defect in 96 Wistar rats. Animals were sacrificed on day 7, 14, 30 and 90 after implantation. At sacrifice the explant (implant and surrounding host tissue) was evaluated for the presence
of herniation, infection, erosion, adhesion formation and
changes in size. Tensile strength was assessed both on
implants and explants. Histopathology was performed to
evaluate collagen deposition and inflammatory response.
ED-1 antibody was used to identify rat macrophages.
Results: While no herniations occurred, two clinical and two
additional pathology confirmed infections were observed,
one in Pelvisoft and three in the Pelvicol group. Pelvitex
induced the least adhesions. At 90 days Vypro II shrunk by
19% while the other materials did not shrink. At 90 days all
materials could resist tensile forces of 16 N/cm Pelvisoft), or higher (Pelvicol, Pelvitex and Vypro II; range: 25–27 N/cm).
Pelvisoft, with its open macroporous construct, had a lower
tensiometric strength than Pelvicol in the early postoperative phase at 14 days. The acute inflammatory response was most pronounced in Vypro II. The chronic inflammatory response and foreign body reaction was comparable in both polypropylene containing materials but more pronounced compared to dermal matrices. Collagen deposition at the interface between muscle and material was comparable for all materials, although it was architecturally more organised in the collagen products.
Conclusion: Pelvisoft has a lesser tensiometric resistance
than Pelvicol on the short term, but not at 90 days, at what
time all materials were equally strong. Pelvitex has a
slightly more attenuated acute inflammatory reaction, with
fewer adhesions than Vypro II. It did neither shrink. Vypro
II induces most adhesions, shrinks by one fifth and induces
the strongest acute inflammation.
ISSN: 0937-3462
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Urology Section (-)
Nutrition (-)
Translational Cell & Tissue Research
Basic Research in Gynaecology Section (-)
× corresponding author
# (joint) last author

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