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Preclinical Bioassay of a Polypropylene Mesh for Hernia Repair Pretreated with Antibacterial Solutions of Chlorhexidine and Allicin: An In Vivo Study.

Pérez-Köhler B, García-Moreno F, Brune T, Pascual G, Bellón JM - PLoS ONE (2015)

Bottom Line: The polypropylene mesh showed improved tissue integration relative to the DualMesh Plus.The implants from the allicin-chlorhexidine group displayed a neoformed tissue containing differently sized abscesses and living bacteria, as well as a diminished macrophage response.The presoaking of reticular polypropylene materials with a low concentration of chlorhexidine provides the mesh with antibacterial activity without disrupting tissue integration.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá. Madrid, Spain.

ABSTRACT

Introduction: Prosthetic mesh infection constitutes one of the major complications following hernia repair. Antimicrobial, non-antibiotic biomaterials have the potential to reduce bacterial adhesion to the mesh surface and adjacent tissues while avoiding the development of novel antibiotic resistance. This study assesses the efficacy of presoaking reticular polypropylene meshes in chlorhexidine or a chlorhexidine and allicin combination (a natural antibacterial agent) for preventing bacterial infection in a short-time hernia-repair rabbit model.

Methods: Partial hernia defects (5 x 2 cm) were created on the lateral right side of the abdominal wall of New Zealand White rabbits (n = 21). The defects were inoculated with 0.5 mL of a 106 CFU/mL Staphylococcus aureus ATCC25923 strain and repaired with a DualMesh Plus antimicrobial mesh or a Surgipro mesh presoaked in either chlorhexidine (0.05%) or allicin-chlorhexidine (900 μg/mL-0.05%). Fourteen days post-implant, mesh contraction was measured and tissue specimens were harvested to evaluate bacterial adhesion to the implant surface (via sonication, S. aureus immunolabeling), host-tissue incorporation (via staining, scanning electron microscopy) and macrophage response (via RAM-11 immunolabeling).

Results: The polypropylene mesh showed improved tissue integration relative to the DualMesh Plus. Both the DualMesh Plus and the chlorhexidine-soaked polypropylene meshes exhibited high bacterial clearance, with the latter material showing lower bacterial yields. The implants from the allicin-chlorhexidine group displayed a neoformed tissue containing differently sized abscesses and living bacteria, as well as a diminished macrophage response. The allicin-chlorhexidine coated implants exhibited the highest contraction.

Conclusions: The presoaking of reticular polypropylene materials with a low concentration of chlorhexidine provides the mesh with antibacterial activity without disrupting tissue integration. Due to the similarities found with the antimicrobial DualMesh Plus material, the chlorhexidine concentration tested could be utilized as a prophylactic treatment to resist infection by prosthetic mesh during hernia repair.

No MeSH data available.


Related in: MedlinePlus

Experimental design.Diagram showing the harvesting and processing of the tissue samples to carry out the macroscopic, microbiological and histological evaluation of the different implants.
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pone.0142768.g002: Experimental design.Diagram showing the harvesting and processing of the tissue samples to carry out the macroscopic, microbiological and histological evaluation of the different implants.

Mentions: Following euthanasia, the implants were examined to score the most relevant macroscopic observations for each specimen using the scoring system shown in Table 1, specifically designed for this purpose. If seroma formation was detected, the liquid was aspirated with a sterile syringe, stored at 4°C until the end of the intervention, and 100 μL of each sample was plated on LB agar plates and incubated at 37°C for 24 h to determine the presence of free-floating bacteria in the seroma. After monitoring the implants, meshes plus surrounding host tissue were harvested from the interfaces of the prosthesis/visceral peritoneum and the prosthesis/subcutaneous tissue for microbiological, morphological and immunohistochemical studies, according to the diagram shown in Fig 2.


Preclinical Bioassay of a Polypropylene Mesh for Hernia Repair Pretreated with Antibacterial Solutions of Chlorhexidine and Allicin: An In Vivo Study.

Pérez-Köhler B, García-Moreno F, Brune T, Pascual G, Bellón JM - PLoS ONE (2015)

Experimental design.Diagram showing the harvesting and processing of the tissue samples to carry out the macroscopic, microbiological and histological evaluation of the different implants.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4640885&req=5

pone.0142768.g002: Experimental design.Diagram showing the harvesting and processing of the tissue samples to carry out the macroscopic, microbiological and histological evaluation of the different implants.
Mentions: Following euthanasia, the implants were examined to score the most relevant macroscopic observations for each specimen using the scoring system shown in Table 1, specifically designed for this purpose. If seroma formation was detected, the liquid was aspirated with a sterile syringe, stored at 4°C until the end of the intervention, and 100 μL of each sample was plated on LB agar plates and incubated at 37°C for 24 h to determine the presence of free-floating bacteria in the seroma. After monitoring the implants, meshes plus surrounding host tissue were harvested from the interfaces of the prosthesis/visceral peritoneum and the prosthesis/subcutaneous tissue for microbiological, morphological and immunohistochemical studies, according to the diagram shown in Fig 2.

Bottom Line: The polypropylene mesh showed improved tissue integration relative to the DualMesh Plus.The implants from the allicin-chlorhexidine group displayed a neoformed tissue containing differently sized abscesses and living bacteria, as well as a diminished macrophage response.The presoaking of reticular polypropylene materials with a low concentration of chlorhexidine provides the mesh with antibacterial activity without disrupting tissue integration.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá. Madrid, Spain.

ABSTRACT

Introduction: Prosthetic mesh infection constitutes one of the major complications following hernia repair. Antimicrobial, non-antibiotic biomaterials have the potential to reduce bacterial adhesion to the mesh surface and adjacent tissues while avoiding the development of novel antibiotic resistance. This study assesses the efficacy of presoaking reticular polypropylene meshes in chlorhexidine or a chlorhexidine and allicin combination (a natural antibacterial agent) for preventing bacterial infection in a short-time hernia-repair rabbit model.

Methods: Partial hernia defects (5 x 2 cm) were created on the lateral right side of the abdominal wall of New Zealand White rabbits (n = 21). The defects were inoculated with 0.5 mL of a 106 CFU/mL Staphylococcus aureus ATCC25923 strain and repaired with a DualMesh Plus antimicrobial mesh or a Surgipro mesh presoaked in either chlorhexidine (0.05%) or allicin-chlorhexidine (900 μg/mL-0.05%). Fourteen days post-implant, mesh contraction was measured and tissue specimens were harvested to evaluate bacterial adhesion to the implant surface (via sonication, S. aureus immunolabeling), host-tissue incorporation (via staining, scanning electron microscopy) and macrophage response (via RAM-11 immunolabeling).

Results: The polypropylene mesh showed improved tissue integration relative to the DualMesh Plus. Both the DualMesh Plus and the chlorhexidine-soaked polypropylene meshes exhibited high bacterial clearance, with the latter material showing lower bacterial yields. The implants from the allicin-chlorhexidine group displayed a neoformed tissue containing differently sized abscesses and living bacteria, as well as a diminished macrophage response. The allicin-chlorhexidine coated implants exhibited the highest contraction.

Conclusions: The presoaking of reticular polypropylene materials with a low concentration of chlorhexidine provides the mesh with antibacterial activity without disrupting tissue integration. Due to the similarities found with the antimicrobial DualMesh Plus material, the chlorhexidine concentration tested could be utilized as a prophylactic treatment to resist infection by prosthetic mesh during hernia repair.

No MeSH data available.


Related in: MedlinePlus