title: Peritoneal effects of prosthetic meshes used to repair abdominal wall defects: monitoring adhesions by sequential laparoscopy.
abstract: BACKGROUND
  The prosthetic materials currently used to repair abdominal wall defects sometimes have to be placed in contact with the visceral peritoneum. This interface is often a site of complications such as intestinal obstruction or fistulas due to adhesions. The aim of this study was to follow the process of adhesion formation in several prosthetic materials by sequential laparoscopy.
  
  
  METHODS
  Defects (7 x 5 cm) were created in the abdominal wall of 30 New Zealand White rabbits and repaired using Surgipro polypropylene mesh (PP), Ultrapro monocryl-prolene mesh (UP), Dual Mesh expanded polytetrafluoroethylene (ePTFE), Composix (PP-ePTFE), Parietex Composite (polyester with collagen-polyethylene glycol-glycerol coating [PO-gl]), or PL-PU99 (PP-polyurethane) patches fixed to the edges of the defect by running polypropylene suture. Adhesions to the implants were laparoscopically determined at 3, 7, and 14 days after surgery.
  
  
  RESULTS
  Percentage adhesion scores were significantly lower for ePTFE, PP-ePTFE, PO-gl, and PP-PU, compared to PP or UP. No differences were observed in adhesion scores recorded at 3, 7, and 14 days postimplant. Reticular prostheses were infiltrated by disorganized scar tissue with fibers concentric to the mesh filaments. In contrast, ePTFE implants were encapsulated by organized tissue, with fibers running parallel to the surface of biomaterial. All three composites achieved good recipient tissue integration and a homogeneous, organized, and well-vascularized neoperitoneum.
  
  
  CONCLUSIONS
  At 14 days postimplant, laminar prostheses and composites showed similar results in terms of adhesion formation and integration within host tissue. Our findings suggest that both the composite prostheses and the laminar ePTFE performed very well in terms of reduced adhesion formation at the peritoneal interface.
authors.affiliation: Department of Surgery, Alcalá University, Madrid, Spain. juanm.bellon@uah.es
authors.forename: Juan M
authors.initials: JM
authors.lastname: Bellón
authors.forename: Marta
authors.initials: M
authors.lastname: Rodríguez
authors.forename: Natalio
authors.initials: N
authors.lastname: García-Honduvilla
authors.forename: Gemma
authors.initials: G
authors.lastname: Pascual
authors.forename: Verónica
authors.initials: V
authors.lastname: Gómez Gil
authors.forename: Julia
authors.initials: J
authors.lastname: Buján
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects; D018450:Disease Progression; D046449:Hernia, Abdominal / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D011108:Polymers / Q000009:adverse effects*; D011817:Rabbits; D013526:Surgical Mesh / Q000009:adverse effects*; D000267:Tissue Adhesions / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology
chemical_list: D001672:Biocompatible Materials; D011108:Polymers