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Coated meshes for hernia repair provide comparable intraperitoneal adhesion prevention

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Abstract

Background

Laparoscopic incisional hernia repair with intraperitoneal mesh is associated with a certain degree of adhesion formation to the mesh. This experimental study examined the efficacy of several coated meshes for adhesion reduction.

Methods

Five commercially available meshes with a layered coating were placed intraperitoneally in rats and followed up for 90 days: polypropylene and polyester meshes, both coated with absorbable collagen (Parietene Composite and Parietex Composite, respectively), and three polypropylene meshes respectively coated with absorbable omega-3 fatty acids (C-Qur Edge), absorbable cellulose (Sepramesh IP), and nonabsorbable expanded polytetrafluoroethylene (Intramesh T1). Uncoated polypropylene and collagen meshs (Parietene and Permacol, respectively) served as the control condition. Adhesions, incorporation, and tissue reaction were evaluated macro- and microscopically. Additionally, the development of the neoperitoneum was examined.

Results

All the coated meshes performed equally well in terms of adhesion reduction. The collagen mesh performed comparably, but the uncoated polypropylene mesh performed significantly worse. The different coatings led to very differing degrees of inflammation. Ingrowth was observed only at the place of suture but was comparable for all the meshes except C-Qur Edge, which showed the weakest incorporation. Development of a neoperitoneum on the mesh surface occurred independently of whether an absorbable or nonabsorbable coating or no coating at all was present.

Conclusions

Commercially available meshes with a layered coating deliver comparable adhesion reduction. The physical presence of a layered coating between the intraperitoneal content and the abdominal wall seems to be more important than the chemical properties of the coating in adhesion formation.

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Acknowledgments

The meshes were supplied unconditionally by the respective manufacturers, whereas none of these were involved in the study design or analysis of results.

Disclosures

Marc H. F. Schreinemacher, Kevin W.Y. van Barneveld, Rieky E. G. Dikmans, Marion J. J. Gijbels, Jan-Willem M. Greve, and Nicole D. Bouvy have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands

    Marc H. F. Schreinemacher, Kevin W. Y. van Barneveld, Rieky E. G. Dikmans & Nicole D. Bouvy

  2. Department of Molecular Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands

    Marion J. J. Gijbels

  3. Department of Pathology, Maastricht University Medical Centre, Maastricht, The Netherlands

    Marion J. J. Gijbels

  4. Department of General Surgery, Atrium Medisch Centrum, Heerlen, The Netherlands

    Jan-Willem M. Greve

Authors
  1. Marc H. F. Schreinemacher
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  2. Kevin W. Y. van Barneveld
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  3. Rieky E. G. Dikmans
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  4. Marion J. J. Gijbels
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  5. Jan-Willem M. Greve
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  6. Nicole D. Bouvy
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Corresponding author

Correspondence to Marc H. F. Schreinemacher.

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Schreinemacher, M.H.F., van Barneveld, K.W.Y., Dikmans, R.E.G. et al. Coated meshes for hernia repair provide comparable intraperitoneal adhesion prevention. Surg Endosc 27, 4202–4209 (2013). https://doi.org/10.1007/s00464-013-3021-5

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  • DOI: https://doi.org/10.1007/s00464-013-3021-5

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