Prevention of adhesion to prosthetic mesh in incisional ventral hernias: comparison of different barriers in an experimental model.
BACKGROUND
The purpose of this study was to compare the intra-abdominal adhesion formation following ventral hernia repair by using oxidized regenerated cellulose (ORC) as a barrier underneath polypropylene mesh (PPM), and sodium hyaluronate/carboxymethylcellulose (HA/CMC)-coated PPM.


METHODS
A ventral abdominal defect was created in each of 30 male rats which were divided into three groups. In group 1 (control) the defect was repaired with PPM; in group 2 ORC was laid over the viscera and the defect was repaired with PPM, and in group 3 HA/CMC-coated PPM was used for the repairing procedure. On the 28th postoperative day all the rats were sacrificed and adhesions were evaluated by laparoscopic exploration followed by histopathological examination.


RESULTS
Animals treated with ORC and PPM, and HA/CMC-coated PPM showed significantly less adhesions than the control group (p = 0.026) and the intra-abdominal adhesions of the rats in these two groups were significantly easier to release than in the control group (p = 0.001). There was no significant difference between the ORC and HA/CMC groups.


CONCLUSIONS
ORC used together with PPM is as effective as HA/CMC-coated PPM and ORC can be used as an adhesion barrier in intra-abdominal hernia repair.
Dilege
E
E
Department of Surgery, Sisli Etfal Teaching and Research Hospital, Sisli, Istanbul, Turkey. edilege@hotmail.com
Coskun
H
H
Gunduz
B
B
Sakiz
D
D
Mihmanli
M
M
D000276:Adjuvants, Immunologic / Q000494:pharmacology; D000818:Animals; D002266:Carboxymethylcellulose Sodium / Q000494:pharmacology*; D002483:Cellulose, Oxidized / Q000494:pharmacology*; D004195:Disease Models, Animal; D006490:Hemostatics / Q000494:pharmacology*; D006555:Hernia, Ventral / Q000601:surgery*; D006820:Hyaluronic Acid / Q000494:pharmacology; D010535:Laparoscopy; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*
D000276:Adjuvants, Immunologic; D002483:Cellulose, Oxidized; D006490:Hemostatics; D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium