Peritoneal adhesions to prosthetic materials: an experimental comparative study of treated and untreated polypropylene meshes placed in the abdominal cavity.
BACKGROUND
Frequently, hernia repair requires polypropylene (PP) meshes, which carry a well-known adhesiogenic risk when placed in contact to the intestine. The aim of this experimental study in a rat model was to assess the role of some materials, when combined with PP, in preventing the adhesions' formation.


METHODS
Sixty male Sprague-Dawley rats were assigned to five groups for intraperitoneal mesh placement: untreated PP, PP+polyurethane (PP+PU), PP+Surgisis (PP+SIS), PP+expanded polytetrafluoroethylene (PP+ePTFE), and a control group without mesh. Twenty-one days and 3 and 6 months after the operation, an assessment of adhesion formation was performed, scoring adhesions in terms of extent and type and the adhesion index (AI; product of adhesions' extent and type).


RESULTS
No significant difference was seen between PP+SIS, PP+PU, and control groups in adhesions extent/quality and in AI. The PP+SIS group had significantly lower adhesions' quality value and AI than PP+ePTFE. PP+PU had significantly lower adhesions' extent/quality value and AI than PP+ePTFE. The control group had adhesions with significantly lower extent/quality and AI than PP+ePTFE. The PP group had significantly more and denser adhesions, compared to PP+ePTFE, as well as a significantly higher AI.


CONCLUSIONS
Adhesions' incidence is reduced by using treated PP meshes. PP+PU and PP+SIS were superior to PP+ePTFE in adhesion prevention.
Ansaloni
Luca
L
Unit of General, Emergency, and Transplant Surgery, St. Orsola-Malpighi University Hospital, Bologna, Italy. luca.ansaloni@aosp.bo.it
Catena
Fausto
F
Coccolini
Federico
F
Fini
Milena
M
Gazzotti
Filippo
F
Giardino
Roberto
R
Pinna
Antonio Daniele
AD
D000005:Abdomen; D000818:Animals; D046449:Hernia, Abdominal / Q000601:surgery*; D008297:Male; D008422:Materials Testing; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D011140:Polyurethanes; D051381:Rats; D017207:Rats, Sprague-Dawley; D018709:Statistics, Nonparametric; D013526:Surgical Mesh / Q000009:adverse effects; D000267:Tissue Adhesions / Q000517:prevention & control*
D011126:Polypropylenes; D011140:Polyurethanes; D011138:Polytetrafluoroethylene