Collagen foil (TissuFoil E) reduces the formation of adhesions when using polypropylene mesh for the repair of experimental abdominal wall defects.
OBJECTIVE
Polypropylene meshes (PPMs) are routinely used in the treatment of incisional hernias to achieve a tension-free closure of the abdominal wall. Severe adhesions are a common cause of intestinal obstruction, or even intestinal fistulas. Using a porcine model, we investigated whether applying a collagen foil (CF) to the undersurface of a PPM will reduce adhesion formation.


METHODS
In ten domestic pigs (20-25 kg), a median laparotomy was performed. In each animal the abdominal wall was reconstructed using three types of closure: simple closure by a running suture (control), PPM only, and PPM covered with CF (PPM-CF). After 6 weeks, the abdominal wall with adherent tissue was resected en bloc for macroscopic (quality and quantity of adhesion formation) and histological work-up.


RESULTS
The PPM-CF showed significantly less severe (1.9 vs 3.0 according to a scoring system), and also less extended (23.8 vs 55.9% total coverage of the mesh), adhesions to the resected abdominal wall. Histological examination revealed fewer and less severe inflammatory reactions, necrosis, and foreign body reactions for the mesh and CF (PPM-CF).


CONCLUSIONS
To combine meshes with the anti-adhesion properties of a CF may be another option to achieve more physiological and more tolerable prosthetic materials.
Schönleben
Frank
F
Chirurgische Klinik mit Poliklinik der Universität Erlangen-Nürnberg, Krankenhausstr.12, 91054 Erlangen, Germany. fs2129@columbia.edu
Reck
Thomas
T
Tannapfel
Andrea
A
Hohenberger
Werner
W
Schneider
Ignaz
I
D000818:Animals; D001672:Biocompatible Materials / Q000494:pharmacology; D024042:Collagen Type I / Q000494:pharmacology*; D003238:Connective Tissue / Q000187:drug effects / Q000473:pathology; D004195:Disease Models, Animal; D005549:Foreign-Body Reaction / Q000209:etiology / Q000517:prevention & control; D046449:Hernia, Abdominal / Q000601:surgery*; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D007274:Injections, Intraperitoneal; D007420:Intestine, Large / Q000473:pathology; D008099:Liver / Q000473:pathology; D008422:Materials Testing; D009336:Necrosis / Q000209:etiology / Q000517:prevention & control; D009852:Omentum / Q000473:pathology; D011126:Polypropylenes / Q000494:pharmacology*; D012720:Severity of Illness Index; D013526:Surgical Mesh / Q000009:adverse effects*; D034421:Sus scrofa; D013536:Suture Techniques; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control
D001672:Biocompatible Materials; D024042:Collagen Type I; D011126:Polypropylenes