Comparison of Adhesive Properties of Five Different Prosthetic Materials Used in Hernioplasty

Abstract

This experimental study was designed to assess and to compare intra-abdominal adhesions following the use of five commercially available prosthetic mesh grafts in the repair if abdominal wall defects. Sixty Wistar albino rats were randomly divided into six groups (n = 10). A 2 x 1 cm defect at abdominal wall was created and defects were closed either primarily or with one of the following prosthetic mesh grafts: monofilament polypropylene, polytetrafluoroethylene, sodium hyaluronate/carboxymethylcellulose-coated polypropylene, polypropylene/polyglactin 910 composite, or resorbable hydrophilic collagen-coated multifiber polyester. The severity of adhesions was graded, tensile strengths of adhesions were measured, and histopathological grades of inflammation and fibrosis were evaluated. Polypropylene mesh resulted in more adhesion formation in comparison to primary repair and other grafts used in this study, except polypropylene/polyglactin 910 composite mesh. In addition, the highest tensile strength of omental adhesions was detected in the polypropylene group (chi2 = 26.249; p = .0001). Polyester composite mesh caused the least adhesion formation among the groups. Sodium hyaluronate/carboxymethylcellulose-coated polypropylene and polyester composite meshes revealed the highest fibrosis scores (chi2 = 50.776; p = .0001). The highest inflammatory activity was detected in the polytetrafluoroethylene mesh group (chi2 = 16.564; p = .005). Thus, sodium hyaluronate/carboxymethylcellulose-coated polypropylene and polytetrafluoroethylene meshes following polyester composite mesh were the minimal adhesion-forming grafts in this study. Disadvantages of the polytetrafluoroethylene mesh were lower fibrotic activity and higher inflammatory reaction to the graft.

Parietex™ Composite mesh versus DynaMesh®-IPOM for laparoscopic incisional and ventral hernia repair: a retrospective cohort study

“…In a small series of patients, DynaMesh ® -IPOM was associated with a high incidence of bowel obstruction caused by adhesion of the whole surface of the mesh to the bowel, with histologically proven severe foreign body reaction in the bowel. 9 Various experimental models and studies suggest decreased adhesion formation with the use of the Parietex™ Composite mesh, [10][11][12][13][14] with most suggesting that coated meshes perform better, with less adhesion formation. The guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias suggest that more research is needed to understand the mesh requirement for individual groups of patients who react differently to different types of mesh.…”

Hyaluronic Acid/Carboxymethylcellulose Membrane Barrier versus Taurolidine for the Prevention of Adhesions to Polypropylene Mesh

“…Surprisingly, the complications of intraperitoneal PPM insertion were not reported as high as expected [13][14][15] . However, due to their favorable antiadherent properties, expensive bilayered prostheses or expanded polytetrafluoroethylene meshes are usually preferred for intra-abdominal application [16][17][18] .…”

Polypropylene Meshes to Prevent Abdominal Herniation. Can Stable Coatings Prevent Adhesions in the Long Term?

“…Others have more or less successfully used different coatings from a biological origin such as sodium hyaluronate/ carboxymethylcellulose 10,26 or an absorbable layer of oxidized regenerated cellulose. 14,15,26 Of course, it remains to be established whether or not these coatings are capable of adhesion prevention in the long term. In view of the fact that biological coatings are susceptible to hydrolytic or enzymatic degradation, it must be expected that these coatings will not provide long-term non-adhesiveness.…”