Long-lasting bioresorbable poly(lactic acid) (PLA94) mesh: a new approach for soft tissue reinforcement based on an experimental pilot study

The purpose of this study was to evaluate host response and soft-tissue regeneration after poly(lactic acid) (PLA) mesh implantation in a rat model, in comparison with light-weight polypropylene (PPL) and poly(glycolic acid) (PGA) meshes. Full-thickeness abdominal wall defects were created in 45 Wistar rats and reconstructed with 15 PLA94, 15 PPL and 15 PGA meshes. Animals were killed on days 7, 30 and 90 to evaluate the presence of adhesions and changes in tensile strength of the implants. Histolopathology and immunohistochemistry were performed to evaluate the collagen deposition and the inflammatory response. Statistics were done using unpaired Student’s t-test, Mann–Whitney rank sum test, Student–Newman–Keuls test and Bonferroni (Dunn) t-test. The inflammatory response induced by the PLA mesh implantation was significantly milder than after PPL mesh. In PLA, vascularity and collagen organization was significantly higher than in PPL and PGA at 30 and 90 days, and collagen composition score was significantly higher than in PPL at 7 and 30 days. In PLA, shrinkage was significantly lower than in PPL and PGA at 7 and 30 days. Elongation at break and tensile strength were comparable between PLA and PPL over the 90-day period. The PLA mesh induces a milder inflammatory response, more orderly collagen deposition than PPL, and preserved comparable tensile strength after 90 days.