Top

Hernia

Published in:

01-12-2011 | Original Article

Histologic evaluation of absorbable and non-absorbable barrier coated mesh secured to the peritoneum with fibrin sealant in a New Zealand white rabbit model

Authors: E. D. Jenkins, L. Melman, S. Desai, C. R. Deeken, S. C. Greco, M. M. Frisella, B. D. Matthews

Published in: Hernia | Issue 6/2011

Abstract

Purpose

The purpose of this study is to evaluate the histologic response to fibrin sealant (FS) as an alternative fixation method for laparoscopic ventral hernia repair.

Methods

One non-absorbable barrier mesh (Composix™) and three absorbable barrier meshes (Sepramesh™, Proceed™, and Parietex™ Composite) were used for the study, with uncoated macroporous polypropylene mesh (ProLite Ultra™) as the control. Three methods of fixation were used: #0-polypropylene suture + FS (ARTISS™, Baxter Healthcare Corp.), FS alone (ARTISS™), or tacks alone (n = 10 for each group). Two pieces of mesh (of dimensions 4 × 4-cm) were secured intraperitoneally in 75 New Zealand white rabbits. After 8 weeks, hematoxylin and eosin (H&E)-stained specimens were evaluated for host tissue response. Statistical significance (P < 0.05) was determined using a one-way analysis of variance (ANOVA) with Fisher’s least significant difference (LSD) post hoc test.

Results

Composix™ with FS only showed significantly greater cellular infiltration than with suture + FS (P = 0.0007), Proceed™ with FS only had significantly greater neovascularization than with suture + FS (P = 0.0172), and ProLite Ultra™ with suture + FS had significantly greater neovascularization than with tacks only (P = 0.046). Differences due to mesh type showed that Composix™ exhibited less extensive cellular infiltration (P ≤ 0.0032), extracellular matrix (ECM) deposition, and neovascularization, and demonstrated less inflammatory cells and more fibroblasts compared to the other meshes (P < 0.05).

Conclusions

FS did not have a significant histologic effect compared to tacks when utilized for the fixation of mesh to the peritoneum of New Zealand White rabbits. However, the mesh type did have a significant histologic effect. The permanent barrier mesh (Composix™) was associated with less histologic incorporation than absorbable barrier and macroporous meshes, as evidenced by lower levels of cellular infiltration, ECM deposition, and neovascularization, independent of the fixation method used.

Available only for authorised users

Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW (1992) Laparoscopic cholecystectomy. The new ‘gold standard’? Arch Surg 127(8):917–923PubMedCrossRef

Smith CD, Weber CJ, Amerson JR (1999) Laparoscopic adrenalectomy: new gold standard. World J Surg 23(4):389–396PubMedCrossRef

Katkhouda N, Mavor E (2000) Laparoscopic splenectomy. Surg Clin North Am 80(4):1285–1297PubMedCrossRef

Heniford BT, Ramshaw BJ (2000) Laparoscopic ventral hernia repair: a report of 100 consecutive cases. Surg Endosc 14(5):419–423PubMedCrossRef

Pierce RA, Spitler JA, Frisella MM, Matthews BD, Brunt LM (2007) Pooled data analysis of laparoscopic vs. open ventral hernia repair: 14 years of patient data accrual. Surg Endosc 21(3):378–386PubMedCrossRef

Carbonell AM, Harold KL, Mahmutovic AJ, Hassan R, Matthews BD, Kercher KW, Sing RF, Heniford BT (2003) Local injection for the treatment of suture site pain after laparoscopic ventral hernia repair. Am Surg 69(8):688–691PubMed

Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg 238(3):391–399PubMed

Karakousis CP, Volpe C, Tanski J, Colby ED, Winston J, Driscoll DL (1995) Use of a mesh for musculoaponeurotic defects of the abdominal wall in cancer surgery and the risk of bowel fistulas. J Am Coll Surg 181(1):11–16PubMed

Katkhouda N, Mavor E, Friedlander MH, Mason RJ, Kiyabu M, Grant SW, Achanta K, Kirkman EL, Narayanan K, Essani R (2001) Use of fibrin sealant for prosthetic mesh fixation in laparoscopic extraperitoneal inguinal hernia repair. Ann Surg 233(1):18–25PubMedCrossRef

10.

Joels CS, Matthews BD, Kercher KW, Austin C, Norton HJ, Williams TC, Heniford BT (2005) Evaluation of adhesion formation, mesh fixation strength, and hydroxyproline content after intraabdominal placement of polytetrafluoroethylene mesh secured using titanium spiral tacks, nitinol anchors, and polypropylene suture or polyglactin 910 suture. Surg Endosc 19(6):780–785PubMedCrossRef

11.

Ceccarelli G, Casciola L, Pisanelli MC, Bartoli A, Di Zitti L, Spaziani A, Biancafarina A, Stefanoni M, Patriti A (2008) Comparing fibrin sealant with staples for mesh fixation in laparoscopic transabdominal hernia repair: a case control-study. Surg Endosc 22(3):668–673PubMedCrossRef

12.

Hickerson WL, Nur I, Meidler R (2011) A comparison of the mechanical, kinetic, and biochemical properties of fibrin clots formed with two different fibrin sealants. Blood Coagul Fibrinolysis 22(1):19–23PubMedCrossRef

13.

Goldenberg MM (2008) Pharmaceutical approval update. Pharm Ther 33(5):299–302

14.

Jenkins ED, Melman L, Frisella MM, Deeken CR, Matthews BD (2010) Evaluation of acute fixation strength of absorbable and nonabsorbable barrier coated mesh secured with fibrin sealant. Hernia 14(5):505–509PubMedCrossRef

15.

Jenkins ED, Melman L, Desai S, Brown SR, Frisella MM, Deeken CR, Matthews BD (2011) Evaluation of intraperitoneal placement of absorbable and nonabsorbable barrier coated mesh secured with fibrin sealant in a New Zealand white rabbit model. Surg Endosc 25(2):604–612PubMedCrossRef

16.

Valentin JE, Badylak JS, McCabe GP, Badylak SF (2006) Extracellular matrix bioscaffolds for orthopaedic applications. A comparative histologic study. J Bone Joint Surg Am 88(12):2673–2686PubMedCrossRef

Title: Histologic evaluation of absorbable and non-absorbable barrier coated mesh secured to the peritoneum with fibrin sealant in a New Zealand white rabbit model
Authors: E. D. Jenkins
L. Melman
S. Desai
C. R. Deeken
S. C. Greco
M. M. Frisella
B. D. Matthews
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Hernia / Issue 6/2011
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-011-0834-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Histologic evaluation of absorbable and non-absorbable barrier coated mesh secured to the peritoneum with fibrin sealant in a New Zealand white rabbit model

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2011

An unusual case of inguinal hernia with spontaneous evisceration

Roles of matrix metalloproteinases in the etiology of inguinal hernia

Growth and trends in publications about abdominal wall hernias and the impact of a specific journal on herniology: a bibliometric analysis

Performing clinical studies involving hernia mesh devices: what every investigator should know about the FDA investigational device exemption (IDE) process

Persistent Müllerian duct syndrome with transverse testicular ectopia presenting as an incarcerated inguinal hernia

Pyoderma gangraenosum as rare complication of incisional hernia repair in a patient with Werlhof’s disease