Comparative Evaluation of Adhesion Formation, Strength of Ingrowth, and Textile Properties of Prosthetic Meshes After Long-Term Intra-Abdominal Implantation in a Rabbit

Novitsky, Yuri W.; Harrell, Andrew G.; Cristiano, Joseph A.; Paton, B. Lauren; Norton, H. James; Peindl, Richard D.; Kercher, Kent W.; Heniford, B. Todd

doi:10.1016/j.jss.2006.09.015

Cited by 135 publications

(103 citation statements)

References 27 publications

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“…Lightweight meshes are designed to mimic the physiology of the abdominal wall, and their tensile strength is adapted to that of tissue [10]. When placed in contact with abdominal viscera, however, macroporous meshes are associated with the formation of bowel adhesions and obstructions, and enterocutaneous fistulae [11]. Therefore, these meshes should be avoided or used in combination with vascularized tissue (e.g., greater omentum, hernia sac) or antiadhesive barriers when contact with the bowel is likely.…”

Section: Introductionmentioning

confidence: 99%

Colonization by human fibroblasts of polypropylene prosthesis in a composite form for hernia repair

Canuto

Saracino

Oraldi

et al. 2012

Hernia

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Purpose: Abdominal wall hernia is one of the commonest surgical disorders world-wide and there is no single gold-standard operative technique to repair it. In an effort to improve techniques and technologies to reinforce hernia repair, synthetic meshes are employed. In this study a new prosthesis (named composite) formed of two polypropylene layers, one macroporous (named mesh) and one transparent (named film) was examined to evaluate its capability to enable cell proliferation without inducing cell death. Inflammatory processes were also examined.Methods: Human fibroblasts BJ were seeded on multiwells, on which composite or film had been placed. After 7, 14 and 21 days, cell growth and viability, deposition of collagen, and release of IL-6, IL-1β and TNF-α were evaluated.Results: The "in vitro" protocol showed the composite to be colonized by human fibroblasts on the polypropylene macroporous mesh side; no cell growth occurred on the film. The slowdown of cell growth observed between 14 and 21 days was accompanied by an increase of type I collagen deposition and marked fibroblast activity. Inflammatory cytokines initially increased, followed by their reduction beginning at 14 days.Conclusions: The new prosthesis comprising two polypropylene layers of differing morphologies can be colonized by fibroblasts on the side facing the abdominal wall, whereas no cell growth occurs on the side facing the viscera. The transient inflammation, observed at early experimental times, is probably important for the healing process.

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Section: Introductionmentioning

confidence: 99%

Colonization by human fibroblasts of polypropylene prosthesis in a composite form for hernia repair

Canuto

Saracino

Oraldi

et al. 2012

Hernia

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“…Dense adhesions followed by fistula formation have continuously reported with an intra-abdominally applied polypropylene mesh graft [3,5]. To avoid adhesions, Attwood et al recommended preperitoneal placement of the mesh graft with the remaining unbreached peritoneum [15].…”

Section: Discussionmentioning

confidence: 99%

“…The cause of adhesions may be ischemia and inflammation of the peritoneum. Increased numbers of fixators, such as staples, have resulted in more trauma and devascularization [3,6]. Foreign bodies are well recognized causes for intraperitoneal adhesions [11].…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic ventral hernia repair (LVHR) has become a standard method for repair of abdominal wall hernias [1][2][3]. In general, the technique consists of a reduction in the hernia contents, transabdominal insertion of an appropriate size and type of mesh, opening of the mesh intraperitoneally, and its fixation over the hernia defect on the posterior surface of the anterior abdominal wall [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Comparative Evaluation of Adhesions to Intraperitoneally Placed Fixation Materials: A Laparoscopic Study in Rats

et al. 2010

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After laparoscopic ventral hernia repair, the nature of the adhesions to fixation materials or to mesh had not been clarified. We examined adhesion formation specific to the fixation material in rats. We designed an experimental laparoscopy setup, and placed four intraperitoneal fixation materials on the peritoneum of rats without a mesh graft. Another group of researchers documented the incidence and intensity of postoperative adhesion formation. The adhesion scores for the nickeltitanium anchor were significantly greater than those for polylactic acid (p=0.004), a titanium tacker (p<0.0001), and fibrin glue (p<0.0001). No adhesions occurred in the fibrin glue group. Fibrin glue is the preferred fixation material because it produced no postoperative adhesions. The nickel-titanium anchor produced heavy adhesions but may be applicable for recurrent hernia cases and in patients with thin abdominal walls.

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“…A scoring system based on the difficulty of adhesiolysis may be used (Table 1). For objective accuracy the force required to separate the adhesion from the trauma site can be measured with a digital force metre [10] (Fig. 2).…”

Section: Operationsmentioning

confidence: 99%

Different approaches for objective scoring of experimental post-operative adhesions in the rat model—a description

et al. 2010

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The formation of peritoneal adhesions is an issue for surgical research. Different adhesion-inducing models with subsequent scoring systems are descriptively published. The lack of uniformity is a problem as the reproducibility of experimental adhesion research depends strongly on the employed scoring system. A uniform, widely-used score that seeks to describe this relevant surgical condition would be beneficial for inter-surgeon comparability. We present and contrast six scoring systems after the traumatisation of the parietal peritoneum in the rat model. Advantages, disadvantages and statistical considerations of these systems are highlighted. Experimental adhesions were created bilaterally in n=11 Wistar rats. This resulted in n=22 adhesion areas. Standardised trauma was inflicted to the parietal peritoneum in a linear shape (20×5 mm) using bipolar electrocautery at 40 W. The defect was closed using five interrupted 3/0 Vicryl sutures placed equidistantly. After 14 days, second look laparotomy was performed and number of adhesions, adhesion coverage, adhesion strength, adhesion quality and the attachment to target organs were scored. A total of 43 adhesions formed at the traumatised areas. All of these adhesions could be scored using the six systems described. The correlation coefficient for adhesion coverage as assessed by a measuring stick versus digital computer analysis of the area was 0.649. Every single scoring approach describes different characteristics of adhesions with non-uniform clinical relevance. A multi-dimensional approach that takes account of statistical considerations is inevitable rather than just the use of limited scoring approaches in the experimental setting.

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Comparative Evaluation of Adhesion Formation, Strength of Ingrowth, and Textile Properties of Prosthetic Meshes After Long-Term Intra-Abdominal Implantation in a Rabbit

Cited by 135 publications

References 27 publications

Colonization by human fibroblasts of polypropylene prosthesis in a composite form for hernia repair

Colonization by human fibroblasts of polypropylene prosthesis in a composite form for hernia repair

Comparative Evaluation of Adhesions to Intraperitoneally Placed Fixation Materials: A Laparoscopic Study in Rats

Different approaches for objective scoring of experimental post-operative adhesions in the rat model—a description

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