Resistance to adhesion formation: a comparative study of treated and untreated mesh products placed in the abdominal cavity.
BACKGROUND
New materials have been devised to prevent postoperative adhesions when placing a prosthesis in contact with abdominal contents.


METHODS
Eighty rats underwent laparotomy and denudation of the serosa of the cecum and peritoneal covering of the abdominal wall. Five treated mesh products (Parietex Composite, Parietene Composite, Bard Composix E/X, Sepramesh, and Gore-Tex Dual Mesh) and one untreated mesh product (untreated Parietene) were randomly placed between the cecum and abdominal wall. A group without mesh was used as control. The animals were sacrificed at 21 days following surgery and analyzed for the presence of adhesions.


RESULTS
The incidence of adhesion formation, mean adhesion area, maximum adhesion length, and strength of adhesion separation were similar between Parietex Composite, Parietene Composite, and Bard Composix E/X, and they were significantly less than with Sepramesh, untreated Parietene, and the control group. Gore-Tex Dual Mesh resulted in less adhesions, adhesion area, mean strength of separation, and work of separation than the untreated Parietene group and the control group. Sepramesh resulted in less strength and work of separation compared to the control group.


CONCLUSIONS
The incidence of adhesions and work and strength of adhesion separation are reduced when using a treated mesh, compared to the untreated mesh and the control group without mesh. Parietex Composite, Parietene Composite, Bard Composix E/X, and Gore-Tex Dual Mesh were superior to Sepramesh, untreated Parietene, and the control group in the prevention of adhesion formation.
Gonzalez
R
R
Hernia Institute, Endosurgery Unit, Surgery Department H-124 B, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322, USA.
Rodeheaver
G T
GT
Moody
D L
DL
Foresman
P A
PA
Ramshaw
B J
BJ
D034841:Abdominal Cavity; D000818:Animals; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D011126:Polypropylenes / Q000627:therapeutic use*; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D011336:Probability; D019919:Prosthesis Implantation; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012016:Reference Values; D012680:Sensitivity and Specificity; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000517:prevention & control*; D014945:Wound Healing / Q000502:physiology
D020099:Coated Materials, Biocompatible; D011126:Polypropylenes; C418228:sepramesh; D011138:Polytetrafluoroethylene