• Franziska Schäfer-Nolte, Kathleen Hennecke, Kerstin Reimers, Reinhild Schnabel, Christina Allmeling, Peter M Vogt, Joern W Kuhbier, and Ursula Mirastschijski.
• From the Department of Plastic, Hand and Reconstructive Surgery, Medical School Hannover, Hannover, Germany. Dr. Mirastschijski is now with Department of Plastic, Reconstructive and Aesthetic Surgery, Klinikum Bremen-Mitte, University of Göttingen, Bremen Germany.
• Ann. Surg.. 2014 Apr 1;259(4):781-92.

ObjectiveThe aim of this study was to investigate biomechanical and immunogenic properties of spider silk meshes implanted as fascia replacement in a rat in vivo model.BackgroundMeshes for hernia repair require optimal characteristics with regard to strength, elasticity, and cytocompatibility. Spider silk as a biomaterial with outstanding mechanical properties is potentially suitable for this application.MethodsCommercially available meshes used for hernia repair (Surgisis and Ultrapro) were compared with handwoven meshes manufactured from native dragline silk of Nephila spp. All meshes were tied onto the paravertebral fascia, whereas sham-operated rats were sutured without mesh implantation. After 4 or 14 days, 4 weeks, and 4 or 8 months, tissue samples were analyzed concerning inflammation and biointegration both by histological and biochemical methods and by biomechanical stability tests.ResultsHistological sections revealed rapid cell migration into the spider silk meshes with increased numbers of giant cells compared with controls with initial decomposition of silk fibers after 4 weeks. Four months postoperatively, spider silk was completely degraded with the formation of a stable scar verified by constant tensile strength values. Surgisis elicited excessive stability loss from day 4 to day 14 (P < 0.001), with distinct inflammatory reaction demonstrated by lymphocyte and neutrophil invasion. Ultrapro also showed decreasing strength and poor elongation behavior, whereas spider silk samples had the highest relative elongation (P < 0.05).ConclusionsHand-manufactured spider silk meshes with good biocompatibility and beneficial mechanical properties seem superior to standard biological and synthetic meshes, implying an innovative alternative to currently used meshes for hernia repair.

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