Modulating the inflammatory response to provide the best environment for healing in the pelvic organ prolapse (POP) repair A preliminary study using coated medical devices.

Abstract

AIM: We studied the inflammatory response in Phosphorylcholine (PC)-coated and uncoated meshes after 4 weeks of implantation in the subcutaneous tissue of the hypogastric region in six patients.

MATERIAL AND METHODS: Six patients underwent POP surgery using two different types of mesh. In three of them a PC-coated mesh was implanted and an uncoated one was implanted in the last three. A small part of the mesh has previously been cut with a standard size decided by the authors and was subsequently implanted in the same time of the pop repair in the subcutaneous fascia of the hypogastric region. After 4 weeks the small part of the mesh was explanted and tissue growth in the fishnet-like mesh was analyzed.

RESULTS: A typical foreign body response formed around the uncoated meshes. On the other hand there was a lack in the inflammatory response around the PC-coated mesh identifying less histiocytes, less giant cells and a thinner fibrous capsule formation.

DISCUSSION: PC polymers have demonstrated excellent biocompatibility and hemocompatibility. The adsorption of protein onto materials’ surface and the trauma involved in surgery necessary for device implantation determines an inflammatory response. The ability of the PC coating to reduce the extent of nonspecific proteins, modulates the specific environment around the implant.

CONCLUSION: This preliminary study showed that modulating the inflammatory response we attempt to provide the best environment for healing.