Human vital amniotic membrane reduces adhesions in experimental intraperitoneal onlay mesh repair
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Various antiadhesive coatings have been proposed for intraperitoneal onlay meshes (IPOM). However, adhesions, mesh infections, and impaired integration remain clinically relevant problems. In this experiment, human vital amniotic membrane (AM) was tested as antiadhesive mesh coating. Vital AM complies with clinical standards of product safety.
In this study, 24 rats were randomized to one control or two treatment groups (n = 8). An uncoated polypropylene mesh (Vitamesh) was implanted using open IPOM technique and fixed with four sutures. In the treatment groups, vital AM was attached to Vitamesh by fibrin sealant fixation. The observation period was 7 and 17 days. Vitamesh fixed by suture only served as the control condition (17 days). Adhesion formation, tissue integration, and neovascularization were assessed macroscopically and histologically.
All the meshes in the control group elicited severe adhesions. Vital AM was highly efficient in reducing adhesions to mesh and sutures. No foreign body reaction or unfavorable immunologic response to vital AM occurred. Tissue integration and neovascularization of coated meshes were good. Fibrin sealant yielded a reliable fixation.
Human vital AM was highly effective in reducing adhesions to polypropylene mesh and sutures in experimental IPOM. No adverse effects were detected, and tissue integration of the mesh was good.
KeywordsAntiadhesives Hernia repair Human amniotic membrane Intraperitoneal mesh placement
This work was partially supported by a Novosanguis grant. We acknowledge the manufacturers’ support with mesh and fibrin sealant and thank Thomas Benesch, PhD, Nadja Walder, MD, Claudia Keibl, Vet, and Alexandra Meinl for their support.
A. H. Petter-Puchner, R. H Fortelny, K. Mika, S. Hennerbichler, H. Redl, and C. Gabriel have no conflicts of interest or financial ties to disclose.
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