Comparative study between two techniques of incisional hernia repair with polypropylene mesh in rabbits

Abstract

Purpose:To compare two different incisional hernia repair techniques (repair with a polypropylene mesh reinforcement on the peritonium-aponeurosis versus polypropylene mesh sutured to the borders of the hernial ring as a bridge) in rabbits. Methods: Incisional hernia was experimentally developed through a 4-cm median incision in 60 rabbits. After 30 days, half of the animals were operated for primary wall closure and placement of a polypropylene mesh reinforcement, while the other half had a polypropylene mesh sutured to the borders of the hernial ring as a bridge. Clinical development, scar breaking strength, as well as gross, microscopic and morphometric parameters were evaluated in all animals 30, 60, and 90 days after repair. Results: No significant differences in breaking strength or histological parameters were observed between groups at any time point studied. No statistical difference regarding complications was detected, although denser and firmer adhesions to the abdominal wall were seen after the mesh was placed as a "bridge". Conclusions: No significant differences between the incisional hernia repair techniques assessed were observed regarding breaking strength, and histological and morphometric parameters. The number of complications was similar in both study groups. However, adhesion of abdominal cavity organs to the scar area was much denser after the placement of a mesh to bridge the defect. Key words: Hernia, Ventral. Polypropylenes. Surgical Mesh. Rabbits. RESUMOObjetivo: Comparar duas técnicas de tratamento da hérnia incisional em coelhos utilizando a tela de polipropileno apoiando um reforço peritônio -aponeurótico ou suturada nas bordas do anel herniário 'em ponte". Métodos: Foram operados 60 coelhos para a produção de hérnia incisional, em uma incisão mediana de 4 centímetros. Após 30 dias, metade dos animais foram operados com o fechamento primário da parede, com colocação de uma tela de polipropileno apoiando o reforço e a outra metade dos animais com a colocação da tela suturada nas bordas do anel herniário "em ponte". Os animais foram avaliados com 30 (M1), 60 (M2)e 90 (M3) dias de pós-operatório. Os parâmetros analisados foram a evolução clínica, análise da força de ruptura da cicatriz, estudo macroscópico, análise microscópica e morfométrica. Resultados: Não foram observadas diferenças significantes com relação a força de ruptura e estudos histológicos nos dois grupos e vários momentos estudados. Não houve diferença estatística com relação às complicações, embora os animais que receberam a tela "em ponte" tiveram aderências mais firmes e intensas à parede abdominal. Conclusões: As duas técnicas utilizadas para correção da hérnia incisional em coelhos não mostraram diferenças significantes quanto a força de ruptura, análise histológica e morfométrica. O número de complicações foi semelhante, porém a aderência de órgãos da cavidade abdominal à área de cicatriz foi muito mais intensa no grupo em que a tela foi colocada "em ponte". Descritores: Hérnia Ventral. Polipropilenos.Tel...

Alloxan diabetes alters the tensile strength, morphological and morphometric parameters of abdominal wall healing in rats

“…In a recent study conducted in our laboratory, we observed a significant reduction in the mechanical strength of ileum and colon rat anastomosis using an experimental model of chronic diabetes, with similar characteristics to the one used in this study 7,8 .…”

“…However, diabetes can also impair the healing of surgical wounds by causing delay in the migration of leukocytes and macrophages interfere with the metabolism of collagen and produce changes in the biomechanics of scars 6,7 .…”

“…The abdominal wall has been further studied to analyze the healing of sutures or synthetic materials such as surgical meshes 7,11,12 .…”

Comparative study of peritoneal adhesions after intraperitoneal implantation in rats of meshes of polypropylene versus polypropylene/polyglecaprone versus polyester/porcine collagen

“…The use of polypropylene-only meshes in direct contact with the viscera and intra-abdominal structures resulted in extensive impairment of visceral adhesions. The use of polypropylene-only meshes for the repair of defects in the abdominal wall and in intimate contact with the intra-abdominal viscera, therefore without any separating films, is associated with the appearance of dense and firm adhesions 21 . Paulo et al .…”