Skip to main content
Top
Published in: Hernia 6/2012

01-12-2012 | Original Article

The effect of a chitosan coating on the adhesive potential and tensile strength of polypropylene meshes

Authors: Y. Altınel, E. Öztürk, G. Özkaya, E. Ü. Akyıldız, Y. Ulcay, H. Özgüç

Published in: Hernia | Issue 6/2012

Login to get access

Abstract

Purpose

The polypropylene mesh used for the repair of abdominal wall hernia can cause intraabdominal adhesions. In this study, the effect of chitosan coating of the polypropylene meshes on the adhesion and tensile strength of the meshes was investigated.

Method

After coating polypropylene meshes with 2 % chitosan, 5 × 3 cm patches were prepared. Under general anesthesia, sterile laparotomy was performed in 96 Wistar albino female rats that were equally allocated to 6 groups. In the first group, only laparotomy was performed. In the second group, chitosan was applied to the peritoneal cavity, and the laparotomy was closed. In the third group, polypropylene (prolene) patches were used to close the abdomen; in the fourth group, polypropylene polyglecaprone 25 (ultrapro) mesh patches were used to close the abdomen. In the fifth and sixth groups, chitosan-coated versions of the meshes used in the third and fourth groups, respectively, were applied. All skin incisions were closed in all groups. On the 7th and 21st days, eight randomly selected rats from each group were killed. The abdomen was opened, and the adhesions were evaluated using the diamond score. The tensile strength of the meshes was measured by an Instron 4301 device. The histopathological evaluation of the inflammatory response was performed according to the Ehrlich and Hunt classification.

Results

The adhesion score was comparable among mesh groups but higher when mesh groups were compared with the control and chitosan groups (p<0.001). The tensile strength of meshes did not differ among mesh groups. Histopathologically, meshes with or without chitosan were similar in terms of inflammatory findings.

Conclusions

The chitosan coating did not affect the adhesion potential, the tensile strength, or the inflammatory response of the polypropylene meshes.
Literature
1.
go back to reference Usher FC, Ochsner J, Tuttle LL Jr (1958) Use of marlex mesh in the repair of incisional hernias. Am J Surg 24:969–974 Usher FC, Ochsner J, Tuttle LL Jr (1958) Use of marlex mesh in the repair of incisional hernias. Am J Surg 24:969–974
2.
go back to reference Losanoff JE, Richman BW, Jones JW (2002) Entero-colocutaneous fistula; a late consequence of polypropylene mesh abdominal wall repair: case report and review of the literature. Hernia 6:144–147PubMedCrossRef Losanoff JE, Richman BW, Jones JW (2002) Entero-colocutaneous fistula; a late consequence of polypropylene mesh abdominal wall repair: case report and review of the literature. Hernia 6:144–147PubMedCrossRef
3.
go back to reference Irkorucu O, Ferahköşe Z, Memiş L, Ekinci Ö, Akın M (2009) Reduction of postsurgical adhesion in a rat model: a comparative study. Clinics 64:143–148PubMed Irkorucu O, Ferahköşe Z, Memiş L, Ekinci Ö, Akın M (2009) Reduction of postsurgical adhesion in a rat model: a comparative study. Clinics 64:143–148PubMed
4.
go back to reference Ozturk E, Yılmazlar A, Berhuni S, Yılmazlar T (2010) The effectiveness of local anasthetics in preventing postoperative adhesions in rat models. Tech Coloproctol 14:337–340PubMedCrossRef Ozturk E, Yılmazlar A, Berhuni S, Yılmazlar T (2010) The effectiveness of local anasthetics in preventing postoperative adhesions in rat models. Tech Coloproctol 14:337–340PubMedCrossRef
5.
go back to reference Topal E, Ozturk E, Sen G, Yerci O, Yılmazlar T (2010) A comparison of three fibrinolytic agents in prevention of intraabdominal adhesions. Acta Chir Belg 110:71–75PubMed Topal E, Ozturk E, Sen G, Yerci O, Yılmazlar T (2010) A comparison of three fibrinolytic agents in prevention of intraabdominal adhesions. Acta Chir Belg 110:71–75PubMed
6.
go back to reference Yılmazlar T, Kaya E, Gürpınar E, Emiroğlu H (1996) Efficacy of tenoxicam on intra-abdominal adhesion prevention in a rat model. J Int Med Res 24:352–357PubMed Yılmazlar T, Kaya E, Gürpınar E, Emiroğlu H (1996) Efficacy of tenoxicam on intra-abdominal adhesion prevention in a rat model. J Int Med Res 24:352–357PubMed
7.
go back to reference Bachman S, Ramshaw B (2008) Prostetic material in ventral hernia repair: how do I choose? Surg Clin N Am 88:101–112PubMedCrossRef Bachman S, Ramshaw B (2008) Prostetic material in ventral hernia repair: how do I choose? Surg Clin N Am 88:101–112PubMedCrossRef
8.
go back to reference Alves NM, Mano JF (2008) Chitosan derivatives obtained by chemical modification for biomedical and environmental applications. Int J Biol Macromol 43:401–414PubMedCrossRef Alves NM, Mano JF (2008) Chitosan derivatives obtained by chemical modification for biomedical and environmental applications. Int J Biol Macromol 43:401–414PubMedCrossRef
9.
go back to reference Rao SB, Sharma CP (1997) Use of chitosan as a biomaterial:studies on its safety and hemostatic potential. J Biomed Mater Res 34:21–28PubMedCrossRef Rao SB, Sharma CP (1997) Use of chitosan as a biomaterial:studies on its safety and hemostatic potential. J Biomed Mater Res 34:21–28PubMedCrossRef
10.
go back to reference Shankaran V, Weber DJ, Reed L (2011) Areview of prosthetics for ventral hernia repair. Ann Surg 253:16–26PubMedCrossRef Shankaran V, Weber DJ, Reed L (2011) Areview of prosthetics for ventral hernia repair. Ann Surg 253:16–26PubMedCrossRef
11.
12.
go back to reference Schneider A, Bennek J, Olsen K (2006) Experimental study evaluating the effect of a barrier method on postoperative intraabdominal adhesions. Dig Dis Sci 51:566–570PubMedCrossRef Schneider A, Bennek J, Olsen K (2006) Experimental study evaluating the effect of a barrier method on postoperative intraabdominal adhesions. Dig Dis Sci 51:566–570PubMedCrossRef
13.
go back to reference Phillips JD, Kim CS, Folkalsrud EW (1992) Effects of chronic corticosteroids and vitamin A on the healing of intestinal anastomoses. Am J Surg 163:71–77PubMedCrossRef Phillips JD, Kim CS, Folkalsrud EW (1992) Effects of chronic corticosteroids and vitamin A on the healing of intestinal anastomoses. Am J Surg 163:71–77PubMedCrossRef
14.
go back to reference Zhou J, Elson C, Le TD (2004) Reduction in postoperative adhesion formation and re-formation after an abdominal operation with the use of N, O-carboxymethyl chitosan. Surgery 135:307–312PubMedCrossRef Zhou J, Elson C, Le TD (2004) Reduction in postoperative adhesion formation and re-formation after an abdominal operation with the use of N, O-carboxymethyl chitosan. Surgery 135:307–312PubMedCrossRef
15.
go back to reference Risbud M, Hardikar A, Bhonde R (2000) Growth modulation of fibroblasts by chitosan-polyvinyl pyrrolidone hydrogel: implications for wound management? J Biosci 25:25–31PubMedCrossRef Risbud M, Hardikar A, Bhonde R (2000) Growth modulation of fibroblasts by chitosan-polyvinyl pyrrolidone hydrogel: implications for wound management? J Biosci 25:25–31PubMedCrossRef
16.
go back to reference Van der Wal JB, Jeekel J (2007) Biology of the peritoneum in normal homeostasis and after surgical truma. Colorectal Dis 9:9–13PubMedCrossRef Van der Wal JB, Jeekel J (2007) Biology of the peritoneum in normal homeostasis and after surgical truma. Colorectal Dis 9:9–13PubMedCrossRef
17.
go back to reference Zhang Z, Xu S, Zhou X (2006) Preventive effects of chitosan on peritoneal adhesion in rats. W J Gastroenterol 28:4572–4577 Zhang Z, Xu S, Zhou X (2006) Preventive effects of chitosan on peritoneal adhesion in rats. W J Gastroenterol 28:4572–4577
18.
go back to reference Zhou X, Chen S, Liao G et al (2007) Preventive effective of gelatinizedly-modified chitosan film on peritoneal adhesion of different types. World J Gastroenterol 13:1262–1267PubMedCrossRef Zhou X, Chen S, Liao G et al (2007) Preventive effective of gelatinizedly-modified chitosan film on peritoneal adhesion of different types. World J Gastroenterol 13:1262–1267PubMedCrossRef
19.
go back to reference Costain DJ, Kennedy R, Ciona C (1997) Prevention of postsurgical adhesions with NO-carboxymethyl chitosan: examination of the most efficacious preparation and the effect of NO-carboxymethyl chitosan on postsurgical healing. J Surg 121:314–319CrossRef Costain DJ, Kennedy R, Ciona C (1997) Prevention of postsurgical adhesions with NO-carboxymethyl chitosan: examination of the most efficacious preparation and the effect of NO-carboxymethyl chitosan on postsurgical healing. J Surg 121:314–319CrossRef
20.
go back to reference Junge K, Rosch R, Krones CJ (2005) Influence of polyglecaprone 25 (Monocryl) supplementation on the biocompatibility of a polypropylene mesh for hernia repair. Hernia 9:212–217PubMedCrossRef Junge K, Rosch R, Krones CJ (2005) Influence of polyglecaprone 25 (Monocryl) supplementation on the biocompatibility of a polypropylene mesh for hernia repair. Hernia 9:212–217PubMedCrossRef
21.
go back to reference Novitsky YW, Harrell AG, Cristiano JA (2007) Comparative evaluation of adhesion formation, strength of ingrowth, and textile properties of prosthetic meshes after long-term intraabdominal implantation in a rabbit. J Surg Res 140:6–11PubMedCrossRef Novitsky YW, Harrell AG, Cristiano JA (2007) Comparative evaluation of adhesion formation, strength of ingrowth, and textile properties of prosthetic meshes after long-term intraabdominal implantation in a rabbit. J Surg Res 140:6–11PubMedCrossRef
22.
go back to reference Junge K, Binnebösel M, Rosch R (2009) Adhesion formation of a polyvinylidenfluoride/polypropylene mesh for intra-abdominal placement in a rodent animal model. Surg Endosc 23:327–333PubMedCrossRef Junge K, Binnebösel M, Rosch R (2009) Adhesion formation of a polyvinylidenfluoride/polypropylene mesh for intra-abdominal placement in a rodent animal model. Surg Endosc 23:327–333PubMedCrossRef
23.
go back to reference Kramer K, Senninger N, Herbst H (2002) Effective prevention of adhesions with hyaluronate. Arch Surg 137:278–282PubMedCrossRef Kramer K, Senninger N, Herbst H (2002) Effective prevention of adhesions with hyaluronate. Arch Surg 137:278–282PubMedCrossRef
24.
go back to reference Riet M, Burger WA, Bonthuis JJ (2004) Prevention of adhesion formation to polypropylene mesh by collagen coating. Surg Endosc 18:681–685CrossRef Riet M, Burger WA, Bonthuis JJ (2004) Prevention of adhesion formation to polypropylene mesh by collagen coating. Surg Endosc 18:681–685CrossRef
25.
go back to reference Scheidbach H, Tamme C, Tannapfel A (2004) In vivo studies comparing the biocompatibility of various polypropylene meshes and their handling properties during endoscopic total extraperitoneal (TEP) patchplasty. Surg Endosc 18:211–220PubMedCrossRef Scheidbach H, Tamme C, Tannapfel A (2004) In vivo studies comparing the biocompatibility of various polypropylene meshes and their handling properties during endoscopic total extraperitoneal (TEP) patchplasty. Surg Endosc 18:211–220PubMedCrossRef
26.
go back to reference Voskerician G, Jin J, Hunter SA (2009) Human peritoneal membrane reduces the formation of intra-abdominal adhesions in ventral hernia repair: experimental study in a chronic hernia rat model. J Surg Res 157:108–114PubMedCrossRef Voskerician G, Jin J, Hunter SA (2009) Human peritoneal membrane reduces the formation of intra-abdominal adhesions in ventral hernia repair: experimental study in a chronic hernia rat model. J Surg Res 157:108–114PubMedCrossRef
27.
go back to reference Cobb WS, Burns JM, Peindl RD (2006) Textile analysis of heavy weight, mid-weight, and light weight polypropylene mesh in a porcine ventral hernia model. J Surg Res 136:1–7PubMedCrossRef Cobb WS, Burns JM, Peindl RD (2006) Textile analysis of heavy weight, mid-weight, and light weight polypropylene mesh in a porcine ventral hernia model. J Surg Res 136:1–7PubMedCrossRef
28.
go back to reference Çakmak A, Çirpanli Y, Bilensoy E (2009) Antibacterial activity of triclosan chitosan coated graft infection model. I J Pharm 381:214–219 Çakmak A, Çirpanli Y, Bilensoy E (2009) Antibacterial activity of triclosan chitosan coated graft infection model. I J Pharm 381:214–219
Metadata
Title
The effect of a chitosan coating on the adhesive potential and tensile strength of polypropylene meshes
Authors
Y. Altınel
E. Öztürk
G. Özkaya
E. Ü. Akyıldız
Y. Ulcay
H. Özgüç
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Hernia / Issue 6/2012
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-012-0950-1

Other articles of this Issue 6/2012

Hernia 6/2012 Go to the issue