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Reduction of adhesions with autogen tissue-covered polypropylene mesh implants for incisional hernia repair: an experimental study

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Summary

Background

Incisional hernia is a complication that is encountered with a rate of 2–11 % and can lead to morbidity, work loss, and even mortality. Prosthetic materials that are used in hernia repair are still being tested, and the ideal one has not been proposed yet. While the recurrence rates with primary repair are found to be 30–50 %, these rates are decreased to 0–15 % with mesh repair. These rates emphasize the importance of meshes. The most important criteria in their usage are the advantages and disadvantages of types of meshes. Our aim is to cover the mesh with the subject’s own collagen tissue, then to repair the defect with this autogen collagen-covered propylene mesh, and lastly, to prevent or decrease adhesions against the mesh.

Methods

A total of 14 male, healthy, 250–300 g Wistar-Albino rats were included in the study. They were separated into two equal groups as Group A (control group) and Group B (study group). In Group A, full-thickness defects were repaired with polypropylene meshes. In Group B, meshes of the same size were placed under the skins of the rats and excised on the ninth day. After creating a full-thickness defect, it was repaired with the rat’s own mesh. On the 21st day, in both groups, the adhesions between intra-abdominal organs and the mesh were evaluated by two independent observers according to adhesion scoring system. The groups were compared in means of fibrosis and inflammation scores. The pathologist was not informed about which preparate belonged to which group.

Results

In Group A, adhesion area, adhesion strength, inflammation, collagen tissue, and fibroblast activity were significantly higher than Group B.

Conclusions

According to our results, after in-lay placement of autogen tissue-covered polypropylene meshes, adhesions can decrease and complications due to intra-abdominal adhesions can be prevented, and relatively low costs may contribute to health expenditure.

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References

  1. Langer S, Christiansen J. Long-term results after incisional hernia repair. Acta Chir Scand. 1985;151:217–9.

    CAS  PubMed  Google Scholar 

  2. Diener MK, Voss S, Jensen K, Buchler MW, Seiler CM. Elective midline laparotomy closure: the INLINE systematic review and meta-analysis. Ann Surg. 2010;251:843–56.

    Article  PubMed  Google Scholar 

  3. O’Dwyer PJ, Courtney CA. Factors involved in abdominal wall closure and subsequent incisional hernia. Surgeon. 2003;1(1):17–22.

    Article  PubMed  Google Scholar 

  4. Yahchouchy-Chouillard E, Aura T, Picone O, Etienne JC, Fingerhut A. Incisional hernias. I. related risk factors. Dig Surg. 2003;20(1):3–9.

    Article  PubMed  Google Scholar 

  5. Rea R, Falco P, Izzo D, Leongito M, Amato B. Laparocopic ventral hernia repair with primary transparietal closure of the hernial defect. BMC Surg. 2012;12(Suppl. 1):S33.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Altom LK, Snyder CW, Gray SH, Graham LA, Vick CC, Hawn MT. Outcomes of emergent incisional hernia repair. Am Surg. 2011;77(8):971–6.

    PubMed  Google Scholar 

  7. Hunter JD 3rd, Cannon JA. Biomaterials: so many choices, so little time. What are the differences? Clin Colon Rectal Surg. 2014;27(4):134–9.

    Article  PubMed  Google Scholar 

  8. Cevasco M, Itani KM. Ventral hernia repair with synthetic, composite, and biologic mesh: characteristics, indications, and infection profile. Surg Infect (Larchmt). 2012;13(4):209–15.

    Article  Google Scholar 

  9. Brown CN, Finch JG. Which mesh for hernia repair? Ann R Coll Surg Engl. 2010;92(4):272–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Usher FC, Hill JR, Ochsner JL. Hernia repair with Marlex mesh: a comparison of techniques. Surgery. 1959;46:718–24.

    CAS  PubMed  Google Scholar 

  11. Millikan KW. Incisional hernia repair. Surg Clin North Am. 2003;83(5):1223–34.

    Article  PubMed  Google Scholar 

  12. Adotey JM. Incisional hernia: a review. Niger J Med. 2006;15(1):34–43.

    Article  CAS  PubMed  Google Scholar 

  13. Nguyen MT, Berger RL, Hicks SC, Davila JA, Li LT, Kao LS, Liang MK. Comparison of outcomes of synthetic mesh vs suture repair of elective primary ventral herniorrhaphy: a systematic review and meta-analysis. JAMA Surg. 2014;149(5):415–21.

    Article  PubMed  Google Scholar 

  14. Bauer JJ, Salky BA, Gelernt IM, Kreel I. Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE). Ann Surg. 1987;206:765–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Evans DM, McAree K, Guyton DP, et al. Dose dependency and wound healing aspects of the use of tissue plasminogen activator in the prevention of intra-abdominal adhesions. Am J Surg. 1993;165:229–32.

    Article  CAS  PubMed  Google Scholar 

  16. Diamond MP, Linsky CB, Cunningham T, Constantine B, diZerega GS, DeCherney AH. A model for sidewall adhesions in the rabbit: reduction by an absorbable barrier. Microsurgery. 1987;8:197–200.

    Article  CAS  PubMed  Google Scholar 

  17. Ehrlich HP, Hunt TK. The effects of cortisone and anabolic steroids on the tensile strength of healing wounds. Ann Surg. 1969;170:203–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Van’t Riet M, de Vos van Steenwijk PJ, Bonthuis F, Marquet RL, Steyerberg EW, Jeckel J, et al. Prevention of adhesion to prostetic mesh: comparison of different barriers using an incisional hernia model. Ann Surg. 2003;237:123–8.

    Article  Google Scholar 

  19. Greenawalt KE, Butler TJ, Rowe EA, Finneral AC, Garlick DS, Burns JW. Evaluation of sepramesh biosurgical composite in a rabbit hernia repair model. J Surg Res. 2000;94(2):92–8.

    Article  CAS  PubMed  Google Scholar 

  20. Szabo A, Haj M, Waxsman I, Eitan A. Evaluation of seprafilm and amniotic membrane as adhesion prophlaxis in mesh repair of abdominal wall hernia in rats. Eur Surg Res. 2000;32:125–8.

    Article  CAS  PubMed  Google Scholar 

  21. Alponat A, Lakshminarasappa RS, Yavuz N, Goh YMP. Prevention of adhesions by Seprafilm, an absorbable adhesion barrier: an incisional hernia model in rats. Am Surg. 1997;63:818–9.

    CAS  PubMed  Google Scholar 

  22. Besim H, Yalçin Y, Hamamci O, Arslan K, Sonişik M, Korkmaz A, et al. Prevention of intraabdominal adhesions produced by polypropylene mesh. Eur Surg Res. 2002;34:239–43.

    Article  CAS  PubMed  Google Scholar 

  23. Baptista ML, Bonsack ME, Delaney JP. Seprafilm reduces adhesions to polypropylene mesh. Surgery. 2000;128(1):86–92.

    Article  CAS  PubMed  Google Scholar 

  24. Hooker GD, Taylor BM, Driman DK. Prevention of adhesion formation with use of sodium hyaluronate-based bioresorbable membrane in a rat model of ventral hernia repair with polypropylene mesh. Surgery. 1999;125:211–6.

    Article  CAS  PubMed  Google Scholar 

  25. Burger JW, Halm JA, Wijsmuller AR, Raa ST, Jeekel J. Evaluation of new prosthetic meshes for ventral hernia repair. Surg Endosc. 2006;20:1320–5.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. General Surgery Clinic, Istanbul Training and Research Hospital, 34098, Fatih, Istanbul, Turkey

    F. Ersoz, M.M. Deniz MD, Y. Duzkoylu MD, S. Culcu MD,  S. Sari, M.E. Gunes MD, A. Ari MD & K. Buyukasik MD

  2. Pathology Department, Istanbul Training and Research Hospital, Istanbul, Turkey

    E. Pasaoglu MD

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  1. F. Ersoz
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  2. M.M. Deniz MD
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  3. Y. Duzkoylu MD
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  4. S. Culcu MD
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  5. S. Sari
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  6. M.E. Gunes MD
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  7. A. Ari MD
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  8. K. Buyukasik MD
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  9. E. Pasaoglu MD
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Correspondence to Y. Duzkoylu MD.

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Ersoz, F., Deniz, M., Duzkoylu, Y. et al. Reduction of adhesions with autogen tissue-covered polypropylene mesh implants for incisional hernia repair: an experimental study. Eur Surg 47, 133–139 (2015). https://doi.org/10.1007/s10353-015-0320-1

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  • DOI: https://doi.org/10.1007/s10353-015-0320-1

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