Biological Response to Mesh

Summary: Background: To evaluate the biocompatibility of surgical mesh, explanted mesh samples were collected and analysed. Methods: All mesh specimens (N = 347) underwent a detailed clinical work-up and morphological study by conventional light microscopy as well as immunohistochemistry. Results: The mean implantation interval for all mesh samples was approximately 24 months; the reason for explantation in the present data pool included complications such as recurrence (mean 63 %), chronic pain (mean 30 %), infection (mean 21 %) or fistula formation (mean 7 %). All mesh types in this particular database exhibited no significant differences in recurrence rates and infection, but significant differences in chronic pain. Here, the low-weight mesh Vypro® seems to have advantages over heavy-weight mesh modifications. Moreover, histological examination in all specimens revealed a typical foreign body reaction depending on the polymer and the mesh features such as pore size and surface area. Conclusions: Hernia repair with surgical mesh may be complicated by recurrence, chronic pain and infection including fistula formation in the long-term follow-up. The main differences between single-mesh modifications were found in chronic pain. Here, low-weight mesh constructions should show improved patient comfort.