Use of an experimental model to evaluate infection resistance of meshes in abdominal wall surgery

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• 作者：Ramó ; n Pé ; rez-Tanoira ; PhD^a ; ^b ; ^{ramontanoira@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; C. Lé ; vano-Linares ; MD^c ; Á ; . Celdrá ; n-Uriarte ; MD^c ; M.C. Isea-Peñ ; a ; MD^a ; M. Sá ; nchez De Molina ; MD^c ; C. Garcí ; a-Vasquez ; MD^c ; J. Esteban-Moreno ; MD ; PhD^a
• 关键词：Prosthesis ; Surgical site infection ; Abdominal infection ; Biofilm ; Rapidly growing mycobacteria ; Rat model
• 刊名：Journal of Surgical Research
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：206
• 期：2
• 页码：435-441
• 全文大小：703 K

文摘

Staphylococcal species are the most common organisms causing prosthetic mesh infections, however, infections due to rapidly growing mycobacteria are increasing. This study evaluates the resistance of biomaterial for abdominal wall prostheses against the development of postoperative infection in a rat model.

Material and methods

In 75 rats, we intramuscularly implanted three different types of prostheses: (1) low-density polypropylene monofilament mesh (PMM), (2) high-density PMM, and (3) a composite prosthesis composed of low-density PMM and a nonporous hydrophilic film. Meshes were inoculated with a suspension containing 10⁸ colony-forming units of Staphylococcus aureus, Staphylococcus epidermidis, Mycobacterium fortuitum, or Mycobacterium abscessus before wound closure. Animals were sacrificed on the eighth day postoperatively for clinical evaluation, and the implants were removed for bacteriologic analyses.

Results

Prostheses infected with S aureus showed a higher bacterial viability, worse integration, and clinical outcome compared with infection by other bacteria. Composite prostheses showed a higher number of viable colonies of both M fortuitum and Staphylococcus spp., with poorer integration in host tissue. However, when the composite prosthesis was infected with M abscessus, a lower number of viable bacteria were isolated and a better integration was observed compared with infection by other bacteria.

Conclusions

Considering M abscessus, a smaller collagen-free contact surface shows better resistance to infection, however, depending on the type of bacteria, prostheses with a large surface, and covered with collagen shows reduced resistance to infection, worse integration, and worse clinical outcome.