Impact of Mesh Use on Morbidity Following Ventral Hernia Repair With a Simultaneous Bowel Resection

Xourafas, Dimitrios; Lipsitz, Stuart R.; Negro, Paolo; Ashley, Stanley W.; Tavakkolizadeh, Ali

doi:10.1001/archsurg.2010.144

Cited by 60 publications

(37 citation statements)

References 33 publications

(27 reference statements)

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“…These adhesions are fibrous bands that develop between the peritoneal area where the prosthetic material is used and the serosal surface of neighboring organs or between the serosal surfaces of two different organs. The most important factors that trigger adhesion are previous operations, ischemia and foreign objects [1][2][3][4][5][6][7][8][11][12][13] . In this study an indirect trauma was created by forming a defect 2 cm in diameter and then creating the conditions required for adhesion by using polypropylene mesh.…”

Section: Discussionmentioning

confidence: 99%

“…Ventral hernias occur due to a variety of reasons either as a primary condition or as a result of complications arising during surgical procedures (incisional hernia) [1][2][3][4][5] . In situations where there is insufficient healthy tissue or when the hernia rupture is very large, prosthetic materials are used in treatment.…”

Section: Introductionmentioning

confidence: 99%

“…These materials are applied as a patch either above or below the fascia. If the mesh comes into contact with abdominal organs, serious intraabdominal adhesions form [1][2][3][4][5][6][7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

“…The rapid healing potential of the peritoneum and its unique physiological characteristics plays an important role both in the formation of intraabdominal adhesions and their prevention 5,[7][8][9][10][11][12][13] . Peritoneal adhesions generally occur as fibrous bands that develop between the serosal surfaces of nearby organs, and the most important causes are previous operations, foreign objects and ischemia [1][2][3][4][5][6][7][8]11 . Trauma suppresses fibrinolytic activity and stimulates the secretion of histamine and vasoactive kinins, thereby increasing capillary permeability.…”

Section: Introductionmentioning

confidence: 99%

“…Adhesions which develop due to the use of polypropylene mesh can be explained as a foreign body reaction that develops due to the mesh and as a decline in plasminogen activation due to the effect on the parietal layer [7][8][9][10][11][12][13] . Fibrinolytics, anticoagulants, anti-inflammatory agents, antibiotics and a number of materials that create a physical barrier are being studied for their effectiveness in preventing these adhesions which can cause intestinal obstructions, volvulus, infertility and abdominal pain 1,[3][4][5]7,8,11,12,[14][15][16][17][18][19][20] . Dimethyl sulfoxide (DMSO) is used for a variety of purposes in industry.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of the Efficacy of Dimethyl Sulfoxide (DMSO) and Synovial Fluid in the Prevention of Peritoneal Adhesions: Experimental Rabbit Model

Kılıç¹,

KILIÇ²,

Yayla³

et al. 2013

Kafkas Univ Vet Fak Derg

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SummaryThe purpose of this study was to compare the efficacy of dimethyl sulfoxide and synovial fluid (SF) in the prevention of peritoneal adhesions that might develop in connection with the use of mersilen mesh in a ventral hernia model created experimentally in rabbits. The forty rabbits used in the study were divided into four groups of ten. The operation was conducted under intrathecal anesthesia induced with ketamine HCl (20 mg/kg intrathecal) following xylazin HCl (5 mg/kg intramuscular) sedation. A median skin incision was made in rabbits placed on the operating table in the supine position. Then, a defect 2 cm in diameter was created on the linea alba. The defect was repaired with mersilen mesh which had been previously prepared in the shape of a disk. Until the 7 th day after the operation, group I was given 10 ml saline (S) and 1.5 g/kg DMSO, group II was given 7 ml saline, 3 ml synovial fluid (SF) and 1.5 g/kg DMSO, group III was given 7 ml saline and 3 ml SF while group IV (control: C) was given only 10 ml saline. All of these were administered intraperitoneally. At the end of the 10th day, the presence and extent of peritoneal adhesion was checked using Jenkins' (1983) visual adhesion scale by performing a relaparotomy. All of the data obtained from the study was analyzed statistically using the Minitab-16 package program. Tissue samples from the region where the graft was performed were evaluated under a light microscope by staining them with the Hematoxilen-Eosin (HE) and Crossman triple stain method. The results of the adhesion scale were evaluated nonparametrically and statistical calculations were performed with the KruskalWallis test. No statistical difference was found between the groups (P>0.05). The results of histopathological examination revealed that the tissue which covered the graft in all of the groups was fibrous tissue. However, it was determined that the fibrosis was weaker in the DMSO group than it was in the SF-DMSO, SF and S groups. In the end, it was concluded that synovial fluid is effective in preventing postoperative peritoneal adhesions in rabbits in light of both relaparotomic, macroscopic findings and histopathological findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Comparison of the Efficacy of Dimethyl Sulfoxide (DMSO) and Synovial Fluid in the Prevention of Peritoneal Adhesions: Experimental Rabbit Model

Kılıç¹,

KILIÇ²,

Yayla³

et al. 2013

Kafkas Univ Vet Fak Derg

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In vitro and in vivo characteristics of gentamicin‐supplemented polyvinylidenfluoride mesh materials

Klink

Binnebösel

Lambertz

et al. 2012

J Biomedical Materials Res

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To reduce infection rates after mesh implantation antibiotic-coated meshes were designed. The aim of the study was to analyze biocompatibility and in vitro efficiency of a modified gentamicin-supplemented polyvinylidenfluoride mesh. Twenty rats were randomized to two groups (PVDF group and Genta group). Mesh material was implanted subcutaneously. Blood samples were taken to determine the gentamicin serum concentration. Seven and 90 days after mesh implantation, animals were euthanized. The inflammatory tissue response was characterized by analyzing the foreign body granuloma. Cellular immune response was analyzed by immunohistochemical investigations. The collagen type I/III ratio was estimated by crosspolarization microscopy. In vitro agar diffusion test, suspension test, and gentamicin release were characterized. Agar diffusion and suspension test showed efficient antibiotic effects of the mesh in vitro. Serum concentrations of gentamicin showed a peak value 1 h postoperatively with a decline within the next day. The total size of the granuloma was significantly smaller in the Genta group compared to the PVDF group at both points of time. Except of a short period of increased expression of CD68 in the Genta group after 7 days, no further difference was found analyzing cellular immune response. The collagen type I/III ratio was widely constant analyzing the two mesh types without significant differences comparing both mesh materials. A significantly decreased foreign body granuloma formation compared to the pure PVDF mesh group was found. In vitro analysis showed efficient antibiotic effects of the Gentamicin supplementation compared to the pure PVDF mesh.

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Emergency Hernia Surgery: What to Know When Evaluating a Patient with an Incarcerated Hernia

Matthews

Reinke

2019

The SAGES Manual of Acute Care Surgery

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Impact of Mesh Use on Morbidity Following Ventral Hernia Repair With a Simultaneous Bowel Resection

Abstract: We recommend caution in using mesh when performing a ventral hernia repair with a simultaneous bowel resection because of significantly increased postoperative infectious complications. Drain use, defect size, and bowel resection type did not influence outcomes.

Cited by 60 publications

References 33 publications

A Comparison of the Efficacy of Dimethyl Sulfoxide (DMSO) and Synovial Fluid in the Prevention of Peritoneal Adhesions: Experimental Rabbit Model

A Comparison of the Efficacy of Dimethyl Sulfoxide (DMSO) and Synovial Fluid in the Prevention of Peritoneal Adhesions: Experimental Rabbit Model

In vitro and in vivo characteristics of gentamicin‐supplemented polyvinylidenfluoride mesh materials

Emergency Hernia Surgery: What to Know When Evaluating a Patient with an Incarcerated Hernia

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