Abdominal wall hernia repair: a comparison of sepramesh and parietex composite mesh in a rabbit hernia model.
BACKGROUND
This study compared Parietex composite mesh (PCM) with Sepramesh (SM) in terms of strength of tissue incorporation, adhesion formation, and mesh shrinkage, using an animal model.


METHODS
A two-phase, prospective, randomized study using 44 New Zealand white rabbits. Each animal underwent creation of a standardized ventral hernia defect, followed by repair using either SM or PCM. Half of each group was sacrificed and examined at 1 month, and the remainder at 5 months. Outcomes measurements were strength of incorporation (SOI), type and area of adhesions (AA), and mesh shrinkage.


RESULTS
SOI for PCM was much greater than for SM, both at 1 month (60.8 N versus 42.6 N) and 5 months (70.9 N versus 31.5 N). The incidence of bowel adhesions was lower with PCM than SM, both at 1 month (1 versus 6) and at 5 months (0 versus 4). At 5 months, PCM demonstrated lower AA, both as a percentage of the mesh (5.6% versus 12.8%) and in terms of absolute area involved (321 mm(2) versus 840 mm(2)). PCM underwent considerably more shrinkage than SM, at both 1 month (38.2% versus 18.1%) and 5 months (17.4% versus 6.1%).


CONCLUSIONS
PCM demonstrated a substantially stronger SOI, which improved over time, and SOI of SM decreased. PCM was also superior in terms of adhesion prevention, but underwent considerably more shrinkage in this experimental model.
Judge
Timothy W
TW
Department of Surgery, Eisenhower Army Medical Center, Ft Gordon, GA 30905, USA. timothy.judge@se.amedd.army.mil
Parker
David M
DM
Dinsmore
Robert C
RC
D034861:Abdominal Wall / Q000601:surgery; D000818:Animals; D002266:Carboxymethylcellulose Sodium / Q000737:chemistry; D003094:Collagen / Q000737:chemistry; D004195:Disease Models, Animal; D004867:Equipment Design; D006555:Hernia, Ventral / Q000601:surgery*; D006820:Hyaluronic Acid / Q000737:chemistry; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000737:chemistry; D007410:Intestinal Diseases / Q000209:etiology; D009852:Omentum / Q000473:pathology; D010532:Peritoneal Diseases / Q000209:etiology; D011091:Polyesters / Q000737:chemistry; D011126:Polypropylenes / Q000737:chemistry; D011446:Prospective Studies; D011817:Rabbits; D011897:Random Allocation; D013499:Surface Properties; D013526:Surgical Mesh; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology
D011091:Polyesters; D011126:Polypropylenes; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D006820:Hyaluronic Acid; D003094:Collagen; D002266:Carboxymethylcellulose Sodium