Untersuchungen zur entzündlichen Fremdkörperreaktion an humanen Mesh-Explantaten unter Berücksichtigung von Risikofaktoren

The repair of hernies by using mesh implants leads to a chronic inflammatory reaction in the organism with formation of foreign-body granulation interfering with the process of mesh integration. The present paper examines the expression of inflammation parameters CD68, TGFß1, Cox2 as well as the cell proliferation and apoptosis in the tissue of 86 mesh explants. It was the aim to characterise the influence of mesh material, duration of the implantation as well as of risk factors like age, sex, BMI, comorbidity on the mesh-induced foreign-body reaction. Our study verifies that mesh implantation independently of the used material induces a chronic inflammatory reaction, which has also been proved unchanged 11 years after the implantation. Despite the fact that significant differences for the different examinated markers could not be established in the granuloma area, heavyweight, small-pore meshes induced a reinforced macrophage infiltration and inflammatory reaction. In all, significantly more often chronic pain and infects were diagnosed after the implantation of heavyweight, small-pore meshes and the superiority of the lightweight meshes postulated in medical literature was confirmed. The observation that the factors age > 50, BMI > 25 and comorbidity were associated with an altered expression profile for the macrophage marker CD68 indicates that apart from material and structure of the used mesh an individual risk profile can influence the inflammatory reaction. Furthermore, we could prove in this study that young and slim patients show pain significantly more often than old and adipose ones, while the risk of a recurrent hernia was increased for older and adipose patients. Our study shows that apart from mesh material, mesh localisation and technical aspects, the mesh integration, but also the mesh-induced complications of recurrence and pain depend on risk factors like age, BMI and comorbidity.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2008

Author dc:creator

• Fritz, Christina

Contributors dc:contributor

• Schumpelick, Volker

• info:eu-repo/classification/ddc/610
• Implantat
• Entzündung
• Granulierende Entzündung
• Fremdkörper
• Medizin
• Mesh
• inflammation
• risk factors
• foreign-body

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-112548%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A49982