Features of local tissue reaction when using titanium mesh implants for hernioplasty in an experiment

• Chinikov M.A.
• Dzhumanov A.K.
• Volkov A.V.
• Lohonina A.V.
• Eremina I.Z.
• Faibushevich A.G.
• Al-Ariki M.К.M.

Abstract

Background. The use of polypropylene implants in herniology is accompanied by the persistence of chronic inflammation around the implant and degradation of its material. The appearance of new implants makes it necessary to comparatively assess he phenomena of chronic inflammation and the quality of the scar forming at the implantation site.

Aim. To analyze the quality of the emerging connective tissue and signs of local chronic inflammation when using titanium and polypropylene implants for hernioplasty in an experiment.

Material and methods. The study was conducted on 112 laboratory rats. 2 groups were formed: in group 1 (n=56), a titanium mesh implant was installed in animals, in group 2 (n=56) – polypropylene. The animals were removed from the experiment on the 14^th, 30^th, 60^th and 180^th days after surgery. 2 research methods were used: morphometric analysis and polymerase chain reaction (PCR) method with assessment of the levels of mediators of chronic inflammation and markers of connective tissue remodeling.

Results. Morphometric analysis revealed faster formation of connective tissue around titanium mesh implants on the 14^th and 30^th days after surgery (3 points in group 1 vs 2 points in group 2, at p=0.007) with fewer cell layers around the implant filaments (4 points in group 1 vs. 2 points in group 2, at p=0.006) at a late date (60 and 180 days) after surgery. In group 1, significantly less local tissue response to the implant was noted at all time points. The maturity of the connective tissue between the implant filaments was higher in 1 group of animals, as in the early stages after surgery (by 30 days: 4 points in group 1 against 2 points in group 2, at p=0.0052), and in the long-term period (for 180 days: 4 points in group 1 against 3 points in group 2, with p=0.015). The PCR method revealed no differences between the groups in the levels of mediators of chronic inflammation and markers of connective tissue remodeling.

Conclusion. The results obtained indicate the advantage of titanium mesh implants over polypropylene ones.

Keywords: titanium implant; chronic inflammation; connective tissue maturity; morphometry; polymerase chain reaction; hernioplasty

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