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Published in: Hernia 4/2010

01-08-2010 | Original Article

Visceral adhesions to hernia prostheses

Authors: W. B. Gaertner, M. E. Bonsack, J. P. Delaney

Published in: Hernia | Issue 4/2010

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Abstract

Purpose

To report our experience with abdominal adhesion formation to various synthetic and biologic prosthetic materials in a rat ventral hernia model.

Methods

A total of 14 prostheses, nine synthetic, four biologic, and one bioresorbable, were evaluated in the rat. Two synthetic prostheses had bioresorbable coatings and one consisted of synthetic and bioresorbable materials woven together. The model involved the removal from the midline of a 2.5 × 2.5-cm segment of full-thickness ventral abdominal wall with the test prosthetic material sewed into the defect, thus, exposing the viscera directly to one surface of the prosthesis. There were four or more rats in each group. Adhesions were assessed at autopsy 7 days after operation or later. The results were expressed as the percentage area of prosthesis surface involved.

Results

All 14 of the tested prosthetic materials induced adhesions. Vicryl Mesh® and the four biologic varieties had lesser overall adhesion coverage than the bare synthetic prostheses. Sepramesh® developed the least adhesion coverage (15%). The two synthetic materials with bioresorbable coatings had smaller areas involved compared to bare synthetic prostheses.

Conclusions

All of the tested prostheses attracted adhesions. Biologic prostheses had smaller areas of coverage compared to synthetic prostheses. Barrier surfaces on synthetic meshes were associated with a much lesser extent of adhesion involvement.
Literature
1.
go back to reference Anthony T, Bergen PC, Kim LT, Henderson M, Fahey T, Rege RV, Turnage RH (2000) Factors affecting recurrence following incisional herniorrhaphy. World J Surg 24:95–100CrossRefPubMed Anthony T, Bergen PC, Kim LT, Henderson M, Fahey T, Rege RV, Turnage RH (2000) Factors affecting recurrence following incisional herniorrhaphy. World J Surg 24:95–100CrossRefPubMed
2.
go back to reference Hodgson NC, Malthaner RA, Ostbye T (2000) The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg 231:436–442CrossRefPubMed Hodgson NC, Malthaner RA, Ostbye T (2000) The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg 231:436–442CrossRefPubMed
3.
go back to reference Höer J, Lawong G, Klinge U, Schumpelick V (2002) Factors influencing the development of incisional hernia. A retrospective study of 2,983 laparotomy patients over a period of 10 years. Chirurg 73:474–480CrossRefPubMed Höer J, Lawong G, Klinge U, Schumpelick V (2002) Factors influencing the development of incisional hernia. A retrospective study of 2,983 laparotomy patients over a period of 10 years. Chirurg 73:474–480CrossRefPubMed
4.
go back to reference Franz MG, Kuhn MA, Nguyen K, Wang X, Ko F, Wright TE, Robson MC (2001) Transforming growth factor beta-2 lowers the incidence of incisional hernias. J Surg Res 97:109–116CrossRefPubMed Franz MG, Kuhn MA, Nguyen K, Wang X, Ko F, Wright TE, Robson MC (2001) Transforming growth factor beta-2 lowers the incidence of incisional hernias. J Surg Res 97:109–116CrossRefPubMed
5.
go back to reference Heniford BT, Park A, Ramshaw BJ, Voeller G (2000) Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg 190:645–650CrossRefPubMed Heniford BT, Park A, Ramshaw BJ, Voeller G (2000) Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg 190:645–650CrossRefPubMed
6.
go back to reference Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72:70–71CrossRefPubMed Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72:70–71CrossRefPubMed
7.
go back to reference Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583PubMed Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583PubMed
8.
go back to reference Ellis H (1971) The cause and prevention of postoperative intraperitoneal adhesions. Surg Gynecol Obstet 133:497–511PubMed Ellis H (1971) The cause and prevention of postoperative intraperitoneal adhesions. Surg Gynecol Obstet 133:497–511PubMed
9.
go back to reference Clagett GP, Bowers BL, Lopez-Viego MA, Rossi MB, Valentine RJ, Myers SI, Chervu A (1993) Creation of a neo-aortoiliac system from lower extremity deep and superficial veins. Ann Surg 218:239–248CrossRefPubMed Clagett GP, Bowers BL, Lopez-Viego MA, Rossi MB, Valentine RJ, Myers SI, Chervu A (1993) Creation of a neo-aortoiliac system from lower extremity deep and superficial veins. Ann Surg 218:239–248CrossRefPubMed
10.
go back to reference Weibel MA, Majno G (1973) Peritoneal adhesions and their relation to abdominal surgery. A postmortem study. Am J Surg 126:345–353CrossRefPubMed Weibel MA, Majno G (1973) Peritoneal adhesions and their relation to abdominal surgery. A postmortem study. Am J Surg 126:345–353CrossRefPubMed
11.
go back to reference Suslavich FJ, Turner NA, King PS, Brown HK (1989) Intraabdominal adhesions: intraoperative US. Radiology 172:387–388PubMed Suslavich FJ, Turner NA, King PS, Brown HK (1989) Intraabdominal adhesions: intraoperative US. Radiology 172:387–388PubMed
12.
go back to reference Landercasper J, Cogbill TH, Merry WH, Stolee RT, Strutt PJ (1993) Long-term outcome after hospitalization for small-bowel obstruction. Arch Surg 128:765–771PubMed Landercasper J, Cogbill TH, Merry WH, Stolee RT, Strutt PJ (1993) Long-term outcome after hospitalization for small-bowel obstruction. Arch Surg 128:765–771PubMed
13.
go back to reference Hofstetter SR (1981) Acute adhesive obstruction of the small intestine. Surg Gynecol Obstet 152:141–144PubMed Hofstetter SR (1981) Acute adhesive obstruction of the small intestine. Surg Gynecol Obstet 152:141–144PubMed
14.
go back to reference C-QUR™ (2007) Coated mesh products pre-clinical implant studies summary. Atrium C-QUR™ (2007) Coated mesh products pre-clinical implant studies summary. Atrium
15.
go back to reference Baptista ML, Bonsack ME, Felemovicius I, Delaney JP (2000) Abdominal adhesions to prosthetic mesh evaluated by laparoscopy and electron microscopy. J Am Coll Surg 190:271–280CrossRefPubMed Baptista ML, Bonsack ME, Felemovicius I, Delaney JP (2000) Abdominal adhesions to prosthetic mesh evaluated by laparoscopy and electron microscopy. J Am Coll Surg 190:271–280CrossRefPubMed
16.
go back to reference Gaertner WB, Hagerman GF, Felemovicius I, Bonsack ME, Delaney JP (2008) Two experimental models for generating abdominal adhesions. J Surg Res 146:241–245CrossRefPubMed Gaertner WB, Hagerman GF, Felemovicius I, Bonsack ME, Delaney JP (2008) Two experimental models for generating abdominal adhesions. J Surg Res 146:241–245CrossRefPubMed
17.
go back to reference Smaniotto B, Pessole ML, Villanova G, Gomes AP, Martins L, Verner G (1997) Effect of streptokinase in the prevention of intra-abdominal adhesions in the rat. Acta Cir Bras 12:235–239CrossRef Smaniotto B, Pessole ML, Villanova G, Gomes AP, Martins L, Verner G (1997) Effect of streptokinase in the prevention of intra-abdominal adhesions in the rat. Acta Cir Bras 12:235–239CrossRef
18.
go back to reference Otcu S, Ozturk H, Aldemir M, Kilinc N, Dokucu AI (2003) Influence of the platelet-activating factor receptor antagonist BB-882 on intra-abdominal adhesion formation in rats. Eur Surg Res 35:41–45CrossRefPubMed Otcu S, Ozturk H, Aldemir M, Kilinc N, Dokucu AI (2003) Influence of the platelet-activating factor receptor antagonist BB-882 on intra-abdominal adhesion formation in rats. Eur Surg Res 35:41–45CrossRefPubMed
19.
go back to reference Asano T, Takazawa R, Yamato M, Takagi R, Iimura Y, Masuda H, Kihara K, Okano T (2006) Transplantation of an autologous mesothelial cell sheet prepared from tunica vaginalis prevents post-operative adhesions in a canine model. Tissue Eng 12:2629–2637CrossRefPubMed Asano T, Takazawa R, Yamato M, Takagi R, Iimura Y, Masuda H, Kihara K, Okano T (2006) Transplantation of an autologous mesothelial cell sheet prepared from tunica vaginalis prevents post-operative adhesions in a canine model. Tissue Eng 12:2629–2637CrossRefPubMed
20.
go back to reference Alimoglu O, Akcakaya A, Sahin M, Unlu Y, Ozkan OV, Sanli E, Eryilmaz R (2003) Prevention of adhesion formations following repair of abdominal wall defects with prosthetic materials (an experimental study). Hepatogastroenterology 50:725–728PubMed Alimoglu O, Akcakaya A, Sahin M, Unlu Y, Ozkan OV, Sanli E, Eryilmaz R (2003) Prevention of adhesion formations following repair of abdominal wall defects with prosthetic materials (an experimental study). Hepatogastroenterology 50:725–728PubMed
21.
go back to reference Demirturk F, Aytan H, Caliskan AC (2006) Comparison of the adhesion scoring systems used in animal models and assessment of interobserver reproducibility. Aust N Z J Obstet Gynaecol 46:356–359CrossRefPubMed Demirturk F, Aytan H, Caliskan AC (2006) Comparison of the adhesion scoring systems used in animal models and assessment of interobserver reproducibility. Aust N Z J Obstet Gynaecol 46:356–359CrossRefPubMed
22.
go back to reference Felemovicius I, Bonsack ME, Hagerman G, Delaney JP (2004) Prevention of adhesions to polypropylene mesh. J Am Coll Surg 198:543–548CrossRefPubMed Felemovicius I, Bonsack ME, Hagerman G, Delaney JP (2004) Prevention of adhesions to polypropylene mesh. J Am Coll Surg 198:543–548CrossRefPubMed
23.
go back to reference Kligman I, Drachenberg C, Papadimitriou J, Katz E (1993) Immunohistochemical demonstration of nerve fibers in pelvic adhesions. Obstet Gynecol 82:566–568CrossRefPubMed Kligman I, Drachenberg C, Papadimitriou J, Katz E (1993) Immunohistochemical demonstration of nerve fibers in pelvic adhesions. Obstet Gynecol 82:566–568CrossRefPubMed
24.
go back to reference Bachman S, Ramshaw B (2008) Prosthetic material in ventral hernia repair: how do I choose? Surg Clin North Am 88:101–112CrossRefPubMed Bachman S, Ramshaw B (2008) Prosthetic material in ventral hernia repair: how do I choose? Surg Clin North Am 88:101–112CrossRefPubMed
25.
go back to reference Halm JA, de Wall LL, Steyerberg EW, Jeekel J, Lange JF (2007) Intraperitoneal polypropylene mesh hernia repair complicates subsequent abdominal surgery. World J Surg 31:423–429CrossRefPubMed Halm JA, de Wall LL, Steyerberg EW, Jeekel J, Lange JF (2007) Intraperitoneal polypropylene mesh hernia repair complicates subsequent abdominal surgery. World J Surg 31:423–429CrossRefPubMed
26.
go back to reference Moreno-Egea A, Lirón R, Girela E, Aguayo JL (2001) Laparoscopic repair of ventral and incisional hernias using a new composite mesh (Parietex): initial experience. Surg Laparosc Endosc Percutan Tech 11:103–106PubMed Moreno-Egea A, Lirón R, Girela E, Aguayo JL (2001) Laparoscopic repair of ventral and incisional hernias using a new composite mesh (Parietex): initial experience. Surg Laparosc Endosc Percutan Tech 11:103–106PubMed
27.
go back to reference Catena F, Ansaloni L, Gazzotti F, Gagliardi S, Di Saverio S, D’Alessandro L, Pinna AD (2007) Use of porcine dermal collagen graft (Permacol) for hernia repair in contaminated fields. Hernia 11:57–60CrossRefPubMed Catena F, Ansaloni L, Gazzotti F, Gagliardi S, Di Saverio S, D’Alessandro L, Pinna AD (2007) Use of porcine dermal collagen graft (Permacol) for hernia repair in contaminated fields. Hernia 11:57–60CrossRefPubMed
28.
go back to reference Parker DM, Armstrong PJ, Frizzi JD, North JH Jr (2006) Porcine dermal collagen (Permacol) for abdominal wall reconstruction. Curr Surg 63:255–258CrossRefPubMed Parker DM, Armstrong PJ, Frizzi JD, North JH Jr (2006) Porcine dermal collagen (Permacol) for abdominal wall reconstruction. Curr Surg 63:255–258CrossRefPubMed
29.
go back to reference Schreinemacher MH, Emans PJ, Gijbels MJ, Greve JW, Beets GL, Bouvy ND (2009) Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model. Br J Surg 96:305–313CrossRefPubMed Schreinemacher MH, Emans PJ, Gijbels MJ, Greve JW, Beets GL, Bouvy ND (2009) Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model. Br J Surg 96:305–313CrossRefPubMed
30.
go back to reference Arnaud JP, Hennekinne-Mucci S, Pessaux P, Tuech JJ, Aube C (2003) Ultrasound detection of visceral adhesion after intraperitoneal ventral hernia treatment: a comparative study of protected versus unprotected meshes. Hernia 7:85–88CrossRefPubMed Arnaud JP, Hennekinne-Mucci S, Pessaux P, Tuech JJ, Aube C (2003) Ultrasound detection of visceral adhesion after intraperitoneal ventral hernia treatment: a comparative study of protected versus unprotected meshes. Hernia 7:85–88CrossRefPubMed
31.
go back to reference van’t Riet M, Burger JW, Bonthuis F, Jeekel J, Bonjer HJ (2004) Prevention of adhesion formation to polypropylene mesh by collagen coating: a randomized controlled study in a rat model of ventral hernia repair. Surg Endosc 18:681–685CrossRefPubMed van’t Riet M, Burger JW, Bonthuis F, Jeekel J, Bonjer HJ (2004) Prevention of adhesion formation to polypropylene mesh by collagen coating: a randomized controlled study in a rat model of ventral hernia repair. Surg Endosc 18:681–685CrossRefPubMed
32.
go back to reference Gaertner WB, Bonsack ME, Delaney JP (2007) Experimental evaluation of four biologic prostheses for ventral hernia repair. J Gastrointest Surg 11:1275–1285CrossRefPubMed Gaertner WB, Bonsack ME, Delaney JP (2007) Experimental evaluation of four biologic prostheses for ventral hernia repair. J Gastrointest Surg 11:1275–1285CrossRefPubMed
33.
go back to reference Bluebond-Langner R, Keifa ES, Mithani S, Bochicchio GV, Scalea T, Rodriguez ED (2008) Recurrent abdominal laxity following interpositional human acellular dermal matrix. Ann Plast Surg 60:76–80CrossRefPubMed Bluebond-Langner R, Keifa ES, Mithani S, Bochicchio GV, Scalea T, Rodriguez ED (2008) Recurrent abdominal laxity following interpositional human acellular dermal matrix. Ann Plast Surg 60:76–80CrossRefPubMed
34.
go back to reference Misra S, Raj PK, Tarr SM, Treat RC (2008) Results of AlloDerm use in abdominal hernia repair. Hernia 12:247–250CrossRefPubMed Misra S, Raj PK, Tarr SM, Treat RC (2008) Results of AlloDerm use in abdominal hernia repair. Hernia 12:247–250CrossRefPubMed
35.
go back to reference Patton JH Jr, Berry S, Kralovich KA (2007) Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions. Am J Surg 193:360–363CrossRefPubMed Patton JH Jr, Berry S, Kralovich KA (2007) Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions. Am J Surg 193:360–363CrossRefPubMed
36.
go back to reference Kaleya RN (2005) Evaluation of implant/host tissue interactions following intraperitoneal implantation of porcine dermal collagen prosthesis in the rat. Hernia 9:269–276CrossRefPubMed Kaleya RN (2005) Evaluation of implant/host tissue interactions following intraperitoneal implantation of porcine dermal collagen prosthesis in the rat. Hernia 9:269–276CrossRefPubMed
Metadata
Title
Visceral adhesions to hernia prostheses
Authors
W. B. Gaertner
M. E. Bonsack
J. P. Delaney
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Hernia / Issue 4/2010
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-010-0659-y

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