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    Estudo compDa respInflamLocal, morfometria do colágeno e aderências viscerais das telas de eptfe, polipropileno encapsulada com polidioxanona e revestida com celulose oxidada, propileno e propileno revestida com silicone, qdo em contato com as vísce
    (Universidade Federal de São Paulo (UNIFESP), 2014-12-17) Fuziy, Rogerio Aoki [UNIFESP]; Linhares, Marcelo Moura Linhares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: Incisional Hernia repair is a frequent surgery, and the use of prosthetic mesh on an intra peritoneal position remains a challenge. The high recurrence rate in incisional hernias (45 to 54%) after primary suture has stimulated the development of prosthetic meshes. Currently, meshes are the biomaterials implant group most used in medicine, but its implants raises inflammatory complications like seroma, cellulite, chronic pain, and infection. This study aims to compare the visceral adhesions and tissue inflammatory responses and collagen deposition caused by meshes made of ePTFE, polypropylene coated with oxidated cellulose, polypropylene, polypropylene coated with silicon, on an experimental study in rats. Methods: Sixty Wistar rats were divided into four groups according with the mesh implanted: ePTFE mesh (group A) polypropylene mesh covered oxidated cellulose (group B), polypropylene (group C) and polypropylene mesh with silicon on the visceral site (group D). On seventh pos operative day, the region of the implanted mesh was accessed and the adhesions were analyzed by Zuhlke Adhesions score. Hematoxylin-eosin and Masson’s trichrome colorations were used to value the tissue inflammatory reaction with a numeric scale for objective scoring. Imunohistochemistry for COX2 was made. For collagen, picrosirius was used with data reading using the Image Tool computer software. Results The scale adhesion was observed that the group C had the highest percentage of adhesions in the classifications 3 and 4 (more dense) as compared to the groups A, B and D (93% vs. 13%, 0 % and 0 %, respectively, p <0.001). Groups A and C showed the greatest percentage area covered with adhesions when compared to groups B and D (99.8 % and 97.7 % vs 83.2 % and 63.1% , respectively, p < 0.001) , group A showed lower unincorporated area of the mesh compared to groups B , C and D ( 42.1 % vs. 15.4 % , 9.4 % and 14.6 % , respectively , p < 0.001 ) . When evaluating the adhesions to the abdominal viscera, the polypropylene mesh (group C) had the highest rates when compared to groups A, B and D (78.6 % vs. 26.7 %, 53.3 % and 35.7 %, respectively, p < 0.029). The ePTFE mesh (group A) showed seroma or collections in 100% of animals compared to groups B, C and D (66.7 %, 21.4 % and 35.7 %, respectively, p < 0.001). The histological study of the inflammatory response on the seventh postoperative day group A had higher scores in inflammation score compared to Group B, C and D (respectively 20.9 x 20.2, 18.6 and 18.2, p < 0.001). Immunohistochemical study in the seventh pos operative day, there was a higher expression of COX2 (p < 0.001) also in group A, compared to the other groups. There was no difference between groups regarding the morphology of collagen. Conclusions : The density of adhesions was higher in group C and lowest in group D; area covered with adhesions was higher on the groups A and C; the unincorporated area of the mesh was bigger on group A , and there were no differences between the others; there was significant difference between groups when compared to the presence of visceral adhesions , being of greater degree in group C and smaller in group A; the presence of collection, seroma or hematoma was higher in group A and lowest in group C; was significant difference between groups when compared to inflammatory classification, being greater degree in group A and lowest in group D; no significant difference was found between the groups when compared collagen deposition assessed by staining Picrosirus ; the intensity of inflammation assessed by the presence of COX2 was higher in group A and lower in the group D.