title: Chemical adhesion barriers: do they affect the intraperitoneal behavior of a composite mesh?
abstract: BACKGROUND
  The intraperitoneal behavior of a prosthetic material used to repair a hernia is key to the success of the postimplant repair process. This study was designed to laparoscopically examine the real-time behavior of three composite meshes incorporating a chemical adhesion barrier when placed in contact with the visceral peritoneum.
  
  
  METHODS
  The defects of 7 × 5 cm were created in the ventral abdominal wall of 18 New Zealand White rabbits and repaired using Parietex Composite® (n = 6), Sepramesh® (n = 6), or Proceed® (n = 6). At 24 hr, 3, 7, and 14 days postimplant, adhesion formation was quantified by subjecting photographs obtained during laparoscopy to image analysis. At 14 days, specimens of the implants and surrounding host tissue were obtained for histologic, morphometric, and immunohistochemical analyses.
  
  
  RESULTS
  There were no cases of infection and/or rejection of the implant. Adhesion formation followed by laparoscopy 3, 7, and 14 days after implant was significantly lower for Parietex® than the other biomaterials. Degradation of the chemical barrier occurred earliest in Sepramesh®, this barrier being most stable at 14 days for the Parietex® implants. Macrophage counts were significantly greater for Sepramesh®. The thickness of the neoformed peritoneum formed on the three implants varied significantly (p < .05): 276.89 ± 38.87 μm, 84.49 ± 19.05 μm, and 161.97 ± 47.05 μm, respectively for Paritex®, Sepramesh®, and Proceed®.
  
  
  CONCLUSIONS
  (a) The most stable barrier against biodegradation was that of Parietex®; (b) the first postimplant week was the most critical period for adhesion formation; and (c) all three biomaterials showed good intraperitoneal behavior.
authors.affiliation: Department of Surgery, Faculty of Medicine, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, University of Alcalá, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Rodríguez
authors.forename: Gemma
authors.initials: G
authors.lastname: Pascual
authors.forename: Sandra
authors.initials: S
authors.lastname: Sotomayor
authors.forename: Bárbara
authors.initials: B
authors.lastname: Pérez-Köhler
authors.forename: Alberto
authors.initials: A
authors.lastname: Cifuentes
authors.forename: Juan M
authors.initials: JM
authors.lastname: Bellón
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D000818:Animals; D001672:Biocompatible Materials; D004848:Epithelium / Q000502:physiology; D059685:Herniorrhaphy; D007150:Immunohistochemistry; D010535:Laparoscopy; D008297:Male; D010537:Peritoneum / Q000473:pathology*; D011817:Rabbits; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000473:pathology / Q000517:prevention & control*
chemical_list: D001672:Biocompatible Materials