title: Topical vanadate enhances the repair of median laparotomy incisions.
abstract: There are over two million laparotomies performed in the United States each year with an incisional hernia rate between 2% and 11%. A total of 100,000 ventral hernia repairs are undertaken each year with recurrences as high as 50%.
  
  
  
  Full thickness midline fascia incisions from the xiphoid to the pubic symphysis were made in rats. The fascia and/or muscular layer was sutured closed and a gel with 300 μM of sodium orthovanadate or saline was placed over the suture line with the skin closed over it. On day 10, 1-cm strips from the superior, middle, and inferior regions of the abdominal wall were tested for breaking strength and processed for histology.
  
  
  
  The mean wound breaking strength of vanadate-treated wounds was 18.6 ± 2.7 N compared with 9.4 ± 3.6 N for controls (P < 0.0001). Similar quantities of granulation tissue were deposited in treated and control wounds. Fine green birefringence patterns, characteristic of immature connective tissue, were seen in control samples viewed with polarized light. In contrast, vanadate-treated wounds showed thick yellow-orange birefringence patterns characteristics of more mature connective tissue. Using α-smooth muscle actin immunostaining, myofibroblasts were prominent in control incisions, but few were identified in vanadate-treated incisions.
  
  
  
  In rat laparotomy wounds, a single application of vanadate increases wound breaking strength, through enhanced connective tissue organization. These combined data suggest topical application of vanadate immediately after fascial closure will increase wound strength, possibly reducing hernia recurrences in the repaired abdominal wall.
authors.affiliation: Department of Anesthesia, Penn State Hershey Medical Center, Hershey, Pennsylvania; Department of Biology, Dickinson College, Carlisle, Pennsylvania.
authors.forename: Sprague W
authors.initials: SW
authors.lastname: Hazard
authors.affiliation: Department of Biology, Dickinson College, Carlisle, Pennsylvania.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Zwemer
authors.affiliation: Department of Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Mackay
authors.affiliation: Department of Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Srinivas V
authors.initials: SV
authors.lastname: Koduru
authors.affiliation: Department of Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania. Electronic address: dravnic@hmc.psu.edu.
authors.forename: Dino J
authors.initials: DJ
authors.lastname: Ravnic
authors.affiliation: Department of Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: H Paul
authors.initials: HP
authors.lastname: Ehrlich
mesh_terms: D058107:Abdominal Wound Closure Techniques; D000287:Administration, Topical; D000818:Animals; D001696:Biomechanical Phenomena; D003238:Connective Tissue / Q000187:drug effects / Q000502:physiology; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D000069290:Incisional Hernia / Q000517:prevention & control*; D007813:Laparotomy; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D000072836:Surgical Wound / Q000188:drug therapy* / Q000503:physiopathology; D013718:Tensile Strength / Q000187:drug effects; D016896:Treatment Outcome; D014638:Vanadates / Q000494:pharmacology / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology
chemical_list: D004791:Enzyme Inhibitors; D014638:Vanadates
keywords: Hernia; Laparotomy; Scar; Vanadate; Wound healing