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Collagen foil (TissuFoil E) reduces the formation of adhesions when using polypropylene mesh for the repair of experimental abdominal wall defects

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Abstract

Background and aims

Polypropylene meshes (PPMs) are routinely used in the treatment of incisional hernias to achieve a tension-free closure of the abdominal wall. Severe adhesions are a common cause of intestinal obstruction, or even intestinal fistulas. Using a porcine model, we investigated whether applying a collagen foil (CF) to the undersurface of a PPM will reduce adhesion formation.

Methods

In ten domestic pigs (20–25 kg), a median laparotomy was performed. In each animal the abdominal wall was reconstructed using three types of closure: simple closure by a running suture (control), PPM only, and PPM covered with CF (PPM–CF). After 6 weeks, the abdominal wall with adherent tissue was resected en bloc for macroscopic (quality and quantity of adhesion formation) and histological work-up.

Results

The PPM–CF showed significantly less severe (1.9 vs 3.0 according to a scoring system), and also less extended (23.8 vs 55.9% total coverage of the mesh), adhesions to the resected abdominal wall. Histological examination revealed fewer and less severe inflammatory reactions, necrosis, and foreign body reactions for the mesh and CF (PPM–CF).

Conclusion

To combine meshes with the antiadhesion properties of a CF may be another option to achieve more physiological and more tolerable prosthetic materials.

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Acknowledgement

This work was supported by Baxter, Munich, Germany.

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Author notes

  1. Frank Schönleben

    Present address: Columbia University, Physicians & Surgeons, ICRC 10-04, 1130 St. Nicholas Ave, New York, NY, 10032, USA

Authors and Affiliations

  1. Chirurgische Klinik mit Poliklinik der Universität Erlangen-Nürnberg, Krankenhausstr.12, 91054, Erlangen, Germany

    Frank Schönleben, Thomas Reck, Werner Hohenberger & Ignaz Schneider

  2. Institut für Pathologie der Universität Leipzig, Leipzig, Germany

    Andrea Tannapfel

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  1. Frank Schönleben
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Correspondence to Frank Schönleben.

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Schönleben, F., Reck, T., Tannapfel, A. et al. Collagen foil (TissuFoil E) reduces the formation of adhesions when using polypropylene mesh for the repair of experimental abdominal wall defects. Int J Colorectal Dis 21, 840–846 (2006). https://doi.org/10.1007/s00384-006-0091-z

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