Hyaluronic acid/carboxymethylcellulose membrane barrier versus taurolidine for the prevention of adhesions to polypropylene mesh.
BACKGROUND
A hyaluronic acid/carboxymethylcellulose (HA/CMC) membrane is an effective measure to prevent polypropylene mesh induced adhesions. We hypothesized that taurolidine 2% solution might be a cost-effective alternative to decrease adhesion formation.


METHODS
Twenty-four rats were randomized into three groups: mesh alone (group 1), mesh + taurolidine 2% (group 2), and mesh + HA/CMC (group 3). Polypropylene mesh (4 cm2) was used to repair surgically induced anterior abdominal wall defects. Taurolidine 2%or a HA/CMC membrane was used as an antiadhesive measure. The animals were sacrificed 6 weeks after the operation, and adhesions to the prosthetic material were evaluated with digital image analysis.


RESULTS
Group 1 (mesh alone) had the highest adhesion ratio (58.5 +/- 4.8%) compared with groups 2 and 3 (p < 0.05). The differences between groups 2 (mesh + taurolidine 2%; adhesion ratio 42.9 +/- 1.6%) and 3 (mesh + HA/CMC; adhesion ratio 40.3 +/- 3.0%) were not significant (p > 0.05).


CONCLUSIONS
The animals of both treatment groups (2 and 3) had lower adhesion ratios compared with the controls (group 1). In particular, the HA/CMC membrane did not present with a superior antiadhesive effect compared with taurolidine. Therefore, taurolidine is a cost-effective alternative to HA/CMC membranes when a polypropylene mesh is used in direct contact with the abdominal viscera.
Erpek
Hakan
H
Department of Surgery, Adnan Menderes University Medical School, Aydin, Turkey. erpekh@yahoo.com
Tuncyurek
Pars
P
Soyder
Aykut
A
Boylu
Sukru
S
D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use; D008297:Male; D008567:Membranes, Artificial; D011126:Polypropylenes / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control; D051381:Rats; D017208:Rats, Wistar; D013526:Surgical Mesh / Q000009:adverse effects*; D013654:Taurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013829:Thiadiazines / Q000627:therapeutic use*; D000267:Tissue Adhesions / Q000517:prevention & control*
D000970:Antineoplastic Agents; D008567:Membranes, Artificial; D011126:Polypropylenes; D013829:Thiadiazines; D013654:Taurine; C012566:taurolidine; D002266:Carboxymethylcellulose Sodium