The role of pro-inflammatory cytokines in rats after implantation of polypropylene surgical mesh with a coating based on tantalum and its derivatives

Abstract

Since the beginning of the 21st century, polypropylene has become the main material used in hernia plastic surgery. More than 30 types of polypropylene surgical meshes are available in the world, but negative statistics regarding the development of the inflammatory process after implantation still remain disappointing. The development of the inflammatory process after implantation of polypropylene surgical meshes is observed in 30-40% of patients. Polypropylene nets, due to their synthetic nature and special physicochemical properties, can increase this inflammatory reaction. The body’s response to polypropylene materials can lead to encapsulation of the surgical mesh in fibrous tissue, a process designed to isolate the foreign material. This fibrotic reaction can cause discomfort, pain, and dysfunction of the mesh, causing subsequent deformation. In recent years, tantalum has been successfully used to produce biocompatible medical implants in surgery, orthopedics, and orthodontics. The aim of our study was to determine the content of pro-inflammatory cytokines, namely IL-1β and IL-6, in the blood plasma of experimental animals 28 days after implantation of polypropylene surgical meshes coated on the basis of tantalum and its derivatives, in particular tantalum oxide and nitride. The experimental group included 40 male rats of the WAG population. Experimental animals were divided randomly into six groups. With the help of surgical intervention, polypropylene surgical mesh «Omega II standard» (Ukrtehmed, Ukraine) measuring 15x15 mm with different types of coatings was implanted between the abdominal wall and the colon. 28 days after surgery, experimental animals were decapitated by cervical dislocation and blood was immediately collected to determine the content of IL-1β and IL-6 in blood plasma. The data obtained after the conducted studies indicate that coatings made of tantalum and tantalum oxide do not contribute to the emergence of an inflammatory process in comparison with the results of a group of experimental animals that were implanted with a surgical mesh without a coating. In the group of experimental animals, after implantation of a tantalum-based surgical mesh, the content of IL-1β and IL-6 was statistically higher by 14.6% and 21.6%, respectively, compared to the results in intact animals. In the group of experimental animals after implantation of a surgical mesh with a coating based on tantalum oxide, the content of IL-1β and IL-6 was statistically higher by 18.6% and 36.6%, respectively, compared to the results of the group of intact animals. At the same time, in the group of experimental animals after implantation of polypropylene surgical mesh without coating, the content of IL-1β and IL-6 was statistically higher by 72% and 81.6%, respectively, compared to the group of intact animals. As a result, the coating based on tantalum and tantalum oxide demonstrated an excellent anti-inflammatory effect and demonstrated excellent biocompatibility, which indicates to us the possibility of further improvement of surgical meshes with biocompatible coatings to achieve better results in surgical practice.