Peritoneal adhesions to prosthetic materials: choice of mesh for incisional hernia repair.
BACKGROUND
In many cases, incisional hernia repair requires the use of prosthetic materials. The aim of this experimental study in a rat model was to assess the role of polyglactin 910 mesh and fluoropassivated polyester mesh in preventing the formation of adhesions.


METHODS
In the first experiment, the formation of peritoneal adhesions was assessed after insertion of polypropylene, polypropylene combined with polyglactin 910, or no mesh. In the second experiment, adhesion formations were compared after insertion of fluoropassivated polyester, polypropylene, and no mesh.


RESULTS
The first experiment showed no significant difference in adhesion formations between the polypropylene mesh and the combined mesh; however, when no mesh was used, there were significantly fewer adhesions in both experiments (p < 0.01). The second experiment showed a significantly lower degree of adhesions and a lower Adhesion Index after insertion of fluoropassivated polyester mesh than when polypropylene mesh was used (p = 0.04).


CONCLUSIONS
Adding polyglactin 910 mesh to polypropylene mesh to prevent the formation of adhesions is not an effective measure. Fluoropassivated polyester meshes appear to provide a better alternative to the use of polypropylene meshes for incisional hernia repair in humans in terms of the formation of adhesions.
Vrijland
W W
WW
Department of General Surgery, Erasmus University Medical Center, P. O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Bonthuis
F
F
Steyerberg
E W
EW
Marquet
R L
RL
Jeekel
J
J
Bonjer
H J
HJ
D000818:Animals; D005260:Female; D006555:Hernia, Ventral / Q000209:etiology* / Q000517:prevention & control*; D010532:Peritoneal Diseases / Q000209:etiology* / Q000517:prevention & control*; D011091:Polyesters; D011098:Polyglactin 910; D011126:Polypropylenes; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control
D011091:Polyesters; D011126:Polypropylenes; D011098:Polyglactin 910