title: Polypropylene meshes to prevent abdominal herniation. Can stable coatings prevent adhesions in the long term?
abstract: Abdominal surgery is associated with a significant risk for incisional herniation. Hernia repair is routinely performed by implantation of synthetic meshes. Such meshes may cause serious adhesions between the implanted material and organs leading to intestinal obstruction or enterocutaneous fistulas. This study compares three knitted meshes for their capacity to prevent adhesion formation in an in vivo study. The meshes evaluated are polypropylene (Prolene), polypropylene coated with oxygenated regenerated cellulose-in principle-a biodegradable biomaterial (Proceed, and Prolene coated with a nondegradable copolymer of the hydrophilic building block N-vinyl pyrrolidone (NVP) and the hydrophobic building block n-butylmethacrylate (BMA). The meshes were implanted in the abdomen of rats (follow-up 7 or 30 days). After 7 days, the formation of adhesions decreased in the order: Prolene > NVP/BMA-coated Prolene > Proceed; after 30 days, this order changed into: Proceed > Prolene > NVP/BMA-coated Prolene. Both at 7 and at 30 days, Proceed was the only mesh surrounded by macrophage cells that contained foreign materials, presumably degradation products of the (biodegradable) surface coating. The data indicate that long-term protection of implanted meshes against excessive adhesions may be achieved through stable biocompatible hydrogel surface coatings.
authors.affiliation: Department of General Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. pj.emans@orthop.unimaas.nl
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Emans
authors.forename: Marc H F
authors.initials: MH
authors.lastname: Schreinemacher
authors.forename: Marion J J
authors.initials: MJ
authors.lastname: Gijbels
authors.forename: Geerard L
authors.initials: GL
authors.lastname: Beets
authors.forename: Jan-Willem M
authors.initials: JW
authors.lastname: Greve
authors.forename: Leo H
authors.initials: LH
authors.lastname: Koole
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Bouvy
mesh_terms: D000818:Animals; D046449:Hernia, Abdominal / Q000517:prevention & control* / Q000601:surgery; D011109:Polymethacrylic Acids / Q000737:chemistry; D011126:Polypropylenes / Q000737:chemistry*; D011205:Povidone / Q000031:analogs & derivatives / Q000737:chemistry; D051381:Rats; D017208:Rats, Wistar; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000517:prevention & control
chemical_list: D011109:Polymethacrylic Acids; D011126:Polypropylenes; C054377:butyl methacrylate-vinylpyrrolidone copolymer; D011205:Povidone