title: Comparison of prosthetic materials in incisional hernia repair.
abstract: OBJECTIVE
  Incisional hernias are not uncommon after abdominal surgery, but their repair is associated with a high risk of complications, including adhesions and recurrence. Many different types of meshes and adhesion barriers have been developed in an attempt to overcome these problems, some of which we have assessed in a rat model.
  
  
  METHODS
  We made a full-thickness 1.5 x 2.5-cm abdominal wall defect in 30 Sprague-Dawley rats, which were divided into three groups according to the materials used for repair: 2 x 3-cm polypropylene mesh (group 1); expanded polytetrafluoroethylene (PTFE) with double-layer polypropylene mesh (group 2); or polypropylene mesh with oxidized cellulose adhesion barriers (group 3). We assessed adhesion formation, tensile strength, and histopathologic findings.
  
  
  RESULTS
  The mean adhesion scores were 3.3, 1.3, and 0.7, in groups 1, 2, and 3, respectively (P < 0.001). The area involved by adhesions was significantly greater in group 1 than in groups 2 or 3 (P < 0.01, P < 0.05), but there was no significant difference between groups 2 and 3 (P < 0.05). The tensile strength in group 2 was less than that in groups 1 or 3 (P < 0.01, P < 0.05), but there was no significant difference between groups 1 and 3 (P > 0.05).
  
  
  CONCLUSIONS
  Although there was less adhesion formation with PTFE and oxidized cellulose, PTFE not only impaired the tensile strength, but also induced fibrosis and inflammation. An oxidized cellulose adhesion barrier can be safely used in incisional hernia repair to prevent intra-abdominal adhesions.
authors.affiliation: Department of General Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Uygar
authors.initials: U
authors.lastname: Demir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Mihmanli
authors.forename: Halil
authors.initials: H
authors.lastname: Coskun
authors.forename: Ece
authors.initials: E
authors.lastname: Dilege
authors.forename: Ali
authors.initials: A
authors.lastname: Kalyoncu
authors.forename: Ediz
authors.initials: E
authors.lastname: Altinli
authors.forename: Burhan
authors.initials: B
authors.lastname: Gunduz
authors.forename: Banu
authors.initials: B
authors.lastname: Yilmaz
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000494:pharmacology; D002483:Cellulose, Oxidized / Q000494:pharmacology*; D004195:Disease Models, Animal; D006555:Hernia, Ventral / Q000601:surgery*; D008297:Male; D008422:Materials Testing; D011126:Polypropylenes / Q000494:pharmacology*; D011138:Polytetrafluoroethylene / Q000494:pharmacology*; D011183:Postoperative Complications; D011336:Probability; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012680:Sensitivity and Specificity; D013526:Surgical Mesh; D013718:Tensile Strength; D014945:Wound Healing / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; D002483:Cellulose, Oxidized; D011126:Polypropylenes; D011138:Polytetrafluoroethylene