Advertisement

Hernia

, Volume 9, Issue 4, pp 338–343 | Cite as

Composite prostheses for the repair of abdominal wall defects: effect of the structure of the adhesion barrier component

  • J. M. BellónEmail author
  • N. García-Honduvilla
  • N. Serrano
  • M. Rodríguez
  • G. Pascual
  • J. Buján
Original Article

Abstract

The component of a composite prosthesis, which makes contact with the visceral peritoneum, can be reabsorbable or non-reabsorbable, and laminar or reticular. This study was designed to determine whether the composition of this second, barrier component could improve its behavior at this interface. Abdominal wall defects in rabbits were repaired using a polypropylene prosthesis (PP), or the composites Sepramesh (PP+h) or Vicryl (PP+v). Fourteen days after surgery, the implants were evaluated by light and scanning electron microscopy, and immunohistochemistry. Prosthetic areas occupied by adhesions (PP: 71.08±5.09, PP+h: 18.55±4.96, P+v: 69.69±16.81%), neoperitoneal thickness (PP: 256.17±21.68, PP+h: 83.11±19.63, PP+v:213.72±35.90  μm) and macrophage counts (PP: 8.73±1.16, PP+h: 27.33±4.13, PP+v: 31.24±3.08%) showed significant differences (P<0.05). The tested biomaterials induced an optimal recipient tissue infiltration. Least adhesion formation was observed on the PP+h implants. This suggests that the second component, although reabsorbable, should be smooth in structure.

Keywords

Abdominal wall repair Polypropylene Composites Peritoneal adhesions Macrophages 

Notes

Acknowledgments

This study was supported by Grant CICYT - MAT 2004-02114.

References

  1. 1.
    Karakousis CP, Volpe C, Tanski J, Colby EM, Winston J, Driscoll DL (1995). Use of mesh for musculoaponeurotic defects of the abdominal wall in cancer surgery and the risk of bowel fistulas. J Am Coll Surg 181:11–16PubMedGoogle Scholar
  2. 2.
    Leber GE, Garb JL, Alexander AI, William PR (1998). Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 133:378–382CrossRefPubMedGoogle Scholar
  3. 3.
    Chew DK, Choi LH, Rogers AM (2000). Enterocutaneous fistula 14 years after prosthetic mesh repair of a ventral incisional hernia: a life-long risk?. Surgery 127:352–353CrossRefPubMedGoogle Scholar
  4. 4.
    Losanoff JE, Richman BW, Jones JW (2002). Entero-colocutaneous fistula: a late consequence of polypropylene mesh abdominal wall repair: case report and review of the literature. Hernia 6:144–147CrossRefPubMedGoogle Scholar
  5. 5.
    Savioz D, Ludwing C, Leissing C, Bolle JF, Büthler, Morel PH (1997). Repeated macroscopic haematuria caused by intravesical migration of a preperitoneal prosthesis. Eu J Surg 163:631–632Google Scholar
  6. 6.
    Bellón JM, Buján J, Contreras L, Carrera-San Martín A, Jurado F (1996). Comparison of a new type of polytetrafluoroethylene patch (Mycro Mesh) and polypropylene prosthesis (Marlex) for repair of abdominal wall defects. J Am Coll Surg 183:11–18PubMedGoogle Scholar
  7. 7.
    Schein M, Wittmann DH, Aprahamian CC, Condon RE (1995). The abdominal compartment syndrome: the physiological and clinical consequences of elevated intra-abdominal pressure. J Am Coll Surg 180:745–753PubMedGoogle Scholar
  8. 8.
    Bellón JM, Contreras L, Pascual G, Buján J (1999). Neoperitoneal formation after implantation of various biomaterials for the repair of abdominal wall defects in rabbits. Eur J Surg 165: 145–150CrossRefPubMedGoogle Scholar
  9. 9.
    Bellón JM, Contreras L, Buján J, Jurado F (1996). Effect of phosphatidylcholine on the process of peritoneal adhesion following implantation of a polypropylene mesh prosthesis. Biomaterials 17:1369–1372CrossRefPubMedGoogle Scholar
  10. 10.
    Bellón JM, Buján J, Contreras L, Hernando A, Jurado F (1994). Macrophage response to experimental implantation of polypropylene prostheses. Eur Surg Res 26:46–53PubMedCrossRefGoogle Scholar
  11. 11.
    Celdrán A, García-Ureña MA, Bazire P, Marijuan JL (1996). The use of omentum in mesh repair of ventral hernias. Am Surg 62:443–445PubMedGoogle Scholar
  12. 12.
    Bellón JM, García-Honduvilla N, López R, Corrales C, Jurado F, Buján J (2003). In vitro mesothelialization of prosthetic materials designed for the repair of abdominal wall defects. J Mat Sci (Mat in Med) 14: 359–364CrossRefGoogle Scholar
  13. 13.
    Greenawalt KE, Butler TJ, Rowe EA, Finneral AC, Garlick DS, Burns JW (2000). Evaluation of Sepramesh biosurgical composite in a rabbit hernia repair model. J Surg Res 94:92–98CrossRefPubMedGoogle Scholar
  14. 14.
    Felemovicius I, Bonsack ME, Hagerman G, Delaney JP (2004) Prevention of adhesions to polypropylene mesh. J Am Coll Surg 198: 543–548CrossRefPubMedGoogle Scholar
  15. 15.
    Soler M, Verhaeghe P, Essomba A, Sevestre H, Stoppa R (1993). Le traitement des éventrations post-opératoires par prothèse composée (polyester-polyglactine 910). Etude clinique et expérimentale. Ann Chir 47:598–608PubMedGoogle Scholar
  16. 16.
    Jenkins SD, Klamer TW, Parteka JJ, Condon RE (1983). A comparison of prosthetic materials used to repair abdominal wall defects. Surgery 94:392–397PubMedGoogle Scholar
  17. 17.
    Porter JM (1995). A combination of vicryl and Marlex mesh: A technique for abdominal wall closure in difficult cases. J Trauma 39:1178–1180PubMedCrossRefGoogle Scholar
  18. 18.
    Diaz JJ, Gray BW, Dobson JM, Grogan EL, May AK, Miller R, Guy J, O′Neill P, Morris JA (2004). Repair of giant abdominal hernias: does the type of prosthesis matter? Am Surg 70:396–402PubMedGoogle Scholar
  19. 19.
    Klinge U, Schumpelick V, Klosterhalfen B (2001). Functional assessment and tissue response of short- and long-term absorbable surgical meshes. Biomaterials 22:1415–1424CrossRefPubMedGoogle Scholar
  20. 20.
    Baykal A, Onat D, Rasa K, Renda N, Sayek I (1997). Effects of polyglycolic acid and polypropylene meshes on postoperative adhesion formation in mice. World J Surg 21:579–582CrossRefPubMedGoogle Scholar
  21. 21.
    Baptista ML, Bonsack ME, Delaney JP (2000). Seprafilm reduces adhesions to polypropylene mesh. Surgery 128: 86–92CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • J. M. Bellón
    • 1
    Email author
  • N. García-Honduvilla
    • 1
  • N. Serrano
    • 1
  • M. Rodríguez
    • 1
  • G. Pascual
    • 2
  • J. Buján
    • 2
  1. 1.Department of Surgery, Faculty of MedicineAlcalá UniversityAlcalá de Henares, MadridSpain
  2. 2.Department of Medical Specialities, Faculty of MedicineAlcalá UniversityAlcalá de Henares, MadridSpain

Personalised recommendations