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2010 Annual Meeting Abstracts

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Comparative Histopathologic Analysis of Human Biologic Meshes after Short- and Long-term Implantation in Mice
*Sean B Orenstein, *Don L Kreutzer, Yuri W Novitsky
Connecticut Comprehensive Center for Hernia Repair, Department of Surgery, University of Connecticut Health Center, Farmington, CT

OBJECTIVE
The use of biologic mesh (BM) for breast reconstructions and hernia repairs has increased. Modern BMs undergo various proprietary sterilization and processing techniques that likely impact host tissue responses and mesh performance. We aimed to compare histopathologic responses to various human-derived BMs after both short- and long-term implantations in a mouse model.
DESIGN
Five-mm circular samples of three common acellular human dermis matrices (AlloDerm[AD], AlloMax[AM], and FlexHD[FX]) were implanted subcutaneously in C57BL/6 mice. At 1, 4, 8, 12, and 24 weeks post-implantation, mesh/tissue blocks underwent histopathologic analysis using H&E and trichrome stains.
OUTCOME MEASURES
Implantation site inflammation [macrophages and lymphocytes], foreign body reaction (FBR) [foreign body giant cells, mast cells], and collagen deposition/organization.
RESULTS
All meshes induced early tissue inflammation at the implantation site (highest in FX). AD had mild early FBR, and none was seen after 8 weeks. Mild FBR was present throughout the study for AM and FX. Multiple mast cells, indicative of heightened immunoreactivity, were also seen near AM and FX up to 12 weeks. AD was associated with extensive phagocytic macrophage presence and significant new collagen deposition by 24 weeks. Collagen organization was also highest in the AD group. Alternatively, AM and FX were associated with limited new collagen deposition or BM remodeling.
CONCLUSIONS
Although most pronounced in FX, local inflammation was associated with all BMs studied. Heightened immunoreactivity to AM and FX likely lead to limited collagen remodeling and poor mesh integration. AD was associated with the lowest foreign body response and the highest degree of new collagen deposition and organization. Overall, increased biocompatibility of AD may be a key predictor for improved mesh performance following implantation.


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