Polyglycolic Acid Mesh in Experimental Renal Trauma

Abstract

We investigated the efficacy of kidney wrapping with polyglycolic acid (PGA) mesh for control of hemorrhage and preservation of renal function following extensive potentially lethal kidney lacerations in the dog. Wrapping of lacerated kidneys resulted in reapposition of the renal parenchyma and prompt, sustained hemostasis. At 21 days following injury the renal lacerations were well healed. Among five dogs with lacerations involving the entire surface of one kidney, the mean of the ratios of the creatinine clearance of the affected kidney divided by the creatinine clearance of the uninjured contralateral kidney was 0.83 +/- 0.14. Among ten dogs with lacerations confined to the lower pole of one kidney, five were treated by mesh wrapping and five by partial nephrectomy. The mean of the ratios of the creatinine clearance of the affected kidney divided by the creatinine clearance of the uninjured contralateral kidney was 0.93 +/- 0.17 for the former group and 0.58 +/- 0.06 for the latter group. Perirenal infection following kidney wrapping developed in only one dog who had an E. coli bacteriuria at the time of injury. Blood pressure was monitored in eight dogs treated with mesh wrapping. None became hypertensive. These data suggest that PGA mesh may have clinical utility in the management of selected renal injuries in humans.