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Comparison of synthetic mesh types in terms of adherence of Escherichia coli and development of mesh infections in a rat model

Aim: To compare different types of synthetic mesh in terms of adherence of microorganisms and induction of inflammation, and to determine the mesh type associated with the lowest level of infection in an infected environment.

Materials and Methods: Sixty Sprague-Dawley rats were randomly divided into six groups: I: Prolen Mesh (Ethicon) (polypropylene); II: HI-TEX PARP MP (polyethylene tereoxphthalate [PET]+polyether urethane (PEU)); III: Vypro 11 (Ethicon) (polypropylene+polygalactin 910); IV: Motif Mesh (Proxy Biomedical) (expanded polytetrafluoroethylene [ePTFE]; a composite mesh); V: Proceed Mesh (Ethicon) (absorbable oxidised regenerated cellulose tissue [ORC]+polypropylene+absorbable polidioxanon [PDS]); and VI: (a control group without any mesh). Sterile mesh platelets (2 × 2 cm) were implanted into rats and 1.0 × 105 Escherichia coli (ATCC 25922) (in 1 mL) was injected via cannula lateral to each incision. Seventy-two hours later, mesh and tissue samples were obtained and investigated both microscopically and histologically.

Results: In terms of tissue inflammation scores, polypropylene and Proceed meshes yielded significantly higher scores than the control group and the HI-TEX mesh. Upon microbiological evaluation, the HITEX and Proceed mesh groups had significantly higher numbers of E. coli than the other groups.

Conclusions: Polypropylene and ePTFE performed well; the E. coli colonisation rates were low in a rat model of infection. Larger studies are warranted to explore both the short- and long-term utilities of various mesh types placed under infected conditions.

Author(s): Tuna B Budak, Ahmet O Yirmibesoglu, Zeki Yumuk, Abdullah Gunes, Cagri Tiryaki, Ertugrul Kargi, Zulfu Bayhan, Yesim S Gurbuz