The IPOM rabbit model is suitable for investigation of biomaterials in the intra-abdominal position. Our results show that the adhesive potential is significantly influenced by the pore size. However, the extent of the foreign-body reaction seems also to be influenced by the filament structure, respectively, the surface area, favoring monofilament material.
Large-pore PP and co-PVDF-meshes showed comparable good results in the intra-abdominal position, with a reduced inflammatory tissue reaction for co-PVDF. Large pore meshes should be considered an alternative for the development of intraperitoneal onlay meshes.
The intraabdominal placement of a pure PPMC shows a neoperitonealization and perifilamental collagenous ingrowth with almost no adhesions. Coverage with omentum (PPMC-O) or polyglactin mesh (PPMC-V) resulted in a significant increase in inflammation and perifilamentary connective tissue formation.
In prosthetic hernia repair, the mechanical properties of surgical mesh should correspond with those of the fascia being repaired. A mismatch of mechanical properties may result in implant deformation, abdominal wall biomechanics impairment, and recurrent herniation at the edges of the meshes.
Laparotomy closure relies on the incisional edges as anchor for the suture material. The results of these techniques are not satisfying, with failure rates of up to 20%. To investigate the effect of different conventional closure techniques and a novel "bridging technique" on abdominal wall perfusion an animal study was performed in rabbits. Abdominal wall perfusion was measured using the method of dynamic laser-fluorescence videography in the first 72 h of incisional wound healing in 25 animals. Suture tension was controlled with a water-filled polyurethane balloon connected to a pressure detector. The effect of laparotomy closure on abdominal wall tissue perfusion depends significantly on the applied technique and suture tension. Avoiding direct sutures in the incisional edges during laparotomy closure leads to a better tissue perfusion of the incisional region than conventional suture techniques. Suture tension can be controlled and adjusted using a water-filled polyurethane balloon as a pressure sensor.
These results prove the efficacy of PLs in adhesion prevention in two concentrations. The findings reveal an unimpeded healing of anastomoses, laparotomy wounds, and liver incisions at different periods after surgery.
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