Page 101 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Biological and synthetic meshes in ventral hernia repair
coating on the visceral side of the mesh. Biological grafts are collagen meshes derived from bovine, porcine or human skin or other tissue like submucosa or pericardium. A recognisable difference exists between the mesehs in performance characteristics, such as cellular response, strength, biodegradability and susceptibility to infection [19].
Biological meshes are thought to induce fewer adhesions because of increased ‘biocompatibility’ and less foreign body reaction [17]. On the other hand these characteristics may result in less incorporation into the abdominal wall [19]. Furthermore some biological grafts are chemically cross-linked to make them less prone to degradation in vivo. This progress should increase the strength and longevity of the mesh while providing the benefits of a biological scaffold [20, 21].
This study aimed to help in the selection of the appropriate prosthesis
from wide choice of available hernia reinforcement materials. Therefore 6 we compared a commonly used synthetic and a composite mesh with
one cross-linked and two non-cross-linked biological meshes in intra- peritoneal position in a rat model. The meshes were tested in terms of
adhesion formation, shrinkage and incorporation after a period of 30 and
90 days. Additionally, collagen formation after 90 days was determined.
Materials and methods
Study design
In this study, 85 male Wistar rats were randomized into two groups: 50 animals in group A and 35 animals in group B. Both groups were in turn subdivided into five groups corresponding with the five meshes tested, thus resulting in 10 animals per mesh in group A and 7 animals per mesh in group B. After the animals had been humanely killed (group A after 30 days and group B after 90 days), adhesion formation, mesh incorporation, shrinkage, tissue response and collagen formation were scored and compared.
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