Large ventral hernias are a difficult surgical problem. Previous attempts to repair large defects in the abdominal wall with prostheses have been associated with recurrences and infection. A filamentous polylactic acid-carbon tissue mesh is a possible alternative prosthesis. We evaluated and compared polylactic acid-carbon mesh and Marlex mesh in repairing a large defect of the abdominal wall in a rat model. The polylactic acid-carbon mesh led to as strong a repair as Marlex mesh for the same time periods postoperatively; furthermore, no infection was noted with the former, whereas a 5.3 percent incidence of infection was noted with Marlex mesh. One mesh disruption was also noted with Marlex mesh. Polylactic acid-carbon mesh was found to have a more marked fibrotic response and a lesser inflammatory response. Polylactic acid-carbon mesh, therefore, appears to be more biocompatible, with more fibrosis, less inflammatory reaction, and equal strength to Marlex mesh. It is therefore a more appropriate synthetic material for a large ventral herniorrhaphy.
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