Biointegration of barrier membranes with different microstructures in hernia repair: preliminary assessment of morphological aspects

Introduction.It is key to create barrier meshes to prevent adhesive disease and strengthen the anterior abdominal wall during hernioplasty. A promising material for it may be a polymer based on vinylidene fluoride and tetrafluoroethylene (VDF-TeFE). We aimed to do a preliminary assessment of morphological aspects of biointegrating VDF-TeFE meshes with various microstructures during hernioplasty, with the most effective one to be later improved for a full preclinical study. Materials and methods. The research was performed on 40 Chinchilla rabbits divided into 4 equal groups: group 1 underwent laparotomy without mesh implantation, the animals from groups 2–4 received a VDF-TeFE mesh barrier having different microstructures. Results. The 1.9-mm pore size (group 2) promoted the formation of dense connective tissue and the growth of adhesions between the organs, the mesh, and the anterior abdominal wall. Pores with a 0.9-mm diameter (group 3) prevented the formation of adhesions, but did not contribute to the strengthening of the anterior abdominal wall. The hybrid mesh structure (group 4) was the most effective because it prevented recurrence of anterior abdominal wall hernia and contributed to a decrease in the formation of adhesions between intestinal loops and the endoprosthesis. Conclusion.The barrier meshes of a hybrid structure made from VDF-TeFE are promising in hernioplasty to prevent adhesions and hernia recurrence. Further work needs to improve the endoprosthesis by modifying it with drugs that prevent the formation of adhesions. However, this issue requires a more in-depth study. Keywords: biointegration, biopolymers, chronic inflammation, adhesive disease, hernia repair, copolymer of tetrafluoroethylene with vinylidene fluoride (VDF-TeFE)