Page 105 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences
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Biological and synthetic meshes in ventral hernia repair
In the H&E-stained samples the degree of inflammation was scored using the following grading scale: grade 1 (mild inflammatory reaction with a few giant cells, occasional lymphocytes and plasma cells), grade 2 (moderate reaction with giant cells and increased numbers of admixed lymphocytes, plasma cells, eosinophils and neutrophils) and grade 3 (severe inflammatory reaction with micro-abscesses).
Statistical analysis
Because the data were not normally distributed adhesion formation, incorporation, shrinkage and tenacity were compared using nonparametric tests (Kruskal Wallis, Mann Witney). Therefore all results
were presented using the median and the interquartile range (IQR). After
the amount of adhesion formation and the percentage of incorporation
of the mesh edge had been assessed, these parameters were used to determine the Spearman’s rank correlation coefficient (r). All reported
p-values are two-sided and considered significant if lower than 0,05. 6 Statistical analysis was performed using PSAW 17 statistical software
package (IBM SPSS statistics)
Results
During this study involving 85 animals, no animals died prematurely.
Adhesions
At 30 days Parietex Composite showed a significantly smaller percentage of mesh surface covered with adhesions (9%, IQR 3.0-12.8%) than any of the other meshes. Permacol resulted in significantly more adhesions than any of the other meshes (87.5%, IQR 81.0-100.0%) and adhesion coverage with the Prolene mesh was significantly higher than with Strattice (40%, IQR 24.1-61.5%) and Parietex Composite meshes. Surgisis mesh showed coverage of 45% (IQR 7.4-77.5%) of the mesh surface. At 90 days the smallest amount of adhesions was seen with Parietex Composite (5%, IQR 2.0-5.0%) and Strattice (5%, IQR 4.0- 10.0%), both significantly less than Prolene (42%, IQR 36.8-53.6%) and Permacol (74.8%, IQR 37.9-82.7%) (Fig 1). Five Surgisis meshes
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