Extraperitoneal and intraperitoneal behavior of several biological meshes currently used to repair abdominal wall defects.

This study compares the behavior of several cross- and noncrosslinked biomeshes (Permacol®, CollaMend®, Surgisis®, Tutomesh®, and Strattice®) currently used for abdominal wall repair when implanted intraperitoneally and extraperitoneally. Material and Methods. Intraperitoneal (IP) implants were fixed on the parietal peritoneum and partial abdominal wall defects (EP) were repaired using each of the biomeshes, in the rabbit abdominal wall. After 90 days of implant, the biomeshes were examined to assess biomesh degradation, collagen I and III expression (Sirius red staining) and the host macrophage response (immunohistochemistry). Results. Following implant, the thinner noncrosslinked biomeshes Tutomesh and Surgisis, were almost fully degraded in both models. In contrast, Strattice behavior was similar to crosslinked biomeshes, showing negligible degree of degradation. This mesh also showed high expression of collagen I, similar to the crosslinked. The noncrosslinked materials elicited lower macrophage counts, significantly so for Strattice. In IP and EP models, Permacol showed similarly high macrophages while counts were lower for CollaMend and Surgisis in the EP model. Conclusions. The intra or extraperitoneal implant of the different meshes did not affect host tissue incorporation or mesh degradation. The crosslinked biomeshes induced a more intense macrophage response regardless of their IP or EP location.