Adhesion prevention in ventral hernia repair: an experimental study comparing three lightweight porous meshes recommended for intraperitoneal use

• Published in: Hernia : the journal of hernias and abdominal wall surgery Vol. 21; no. 1; pp. 115 - 123
• Main Authors: D’Amore, L., Ceci, F., Mattia, S., Fabbi, M., Negro, P., Gossetti, F.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.02.2017; Springer Nature B.V
• Subjects: Abdominal Surgery; Animals; Biocompatible Materials; Disease Models, Animal; Female; Hernia, Ventral - surgery; Herniorrhaphy - adverse effects; Herniorrhaphy - instrumentation; Medicine; Medicine & Public Health; Original Article; Peritoneum - surgery; Polypropylenes; Polyvinyls; Rats; Rats, Sprague-Dawley; Surgical Mesh - adverse effects; Tissue Adhesions - etiology; Tissue Adhesions - prevention & control; Intraperitoneal adhesions; Omega-3-fatty acids; Experimental ventral hernia; PVDF; IPOM; Titanized polypropylene mesh
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-016-1541-3

Background In ventral hernia repair, when prosthetic material is placed intraperitoneally, it may lead to an inflammatory reaction resulting in adhesions between the mesh and abdominal viscera. Several meshes have been developed to minimize this process. In this experimental study, the ability of different combined meshes to attenuate the adhesion formation was examined. Methods Three commercially available lightweight porous combined meshes were placed intraperitoneally to repair an abdominal wall defect in rats: DynaMesh-IPOM (PVDF + PP), TiMesh (titanium-coated filament PP) and C-QUR/FX (omega-3 fatty acid-coated filament PP). The DynaMesh-CICAT (PVDF) was implanted in the control group. Adhesion formation was macroscopically evaluated and scored after 7 and 21 days. Results All animals except two presented intra-abdominal adhesions. None of the meshes examined in the study demonstrated to prevent adhesions. C-QUR/FX reduced adhesion formation at 7 days’ follow-up compared with all other meshes but by 21 days this effect was diminished. Between 7 and 21 days adhesion extension significantly decreased for TiMesh. TAS did not show significant modifications between 7 and 21 days’ follow-up for each mesh. Conclusions The combined porous meshes tested in the present study demonstrated to reduce but not to prevent the adhesion formation, even if with some differences. Combined porous meshes could be chosen instead of simple meshes for retro-rectus preperitoneal prosthetic ventral hernia repair.