Page 109 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Biological and synthetic meshes in ventral hernia repair
(Zühlke 4) to Permacol in 6 out of 10 (60.0%) and to Strattice in 2 out of 10 (20.0%) cases. At 90 days the Zühlke score of Permacol was significantly higher than the score of Parietex Composite, Surgisis and Strattice. No organs were attached to any of the meshes except for Permacol (4 out of 7, 57.1%) The Zühlke scores for the Strattice (1, IQR 1.0-2.0) and Surgisis meshes (1, IQR 0.0-1.0) were significantly lower than for Prolene (2, IQR 2.0-2.0)
Figure 4. Shrinkage of the mesh surface compared with the original size. At 30 days: §p < 0.050 versus all other meshes; ±p < 0.050 versus Permacol and Strattice. At 90 days: *p < 0.050 versus all other meshes; ¶p < 0.050 versus Prolene. Compared with 30 days, Surgisis, Parietex composite, and Strattice showed significant more shrinkage (Mann–Whitney U test)
Correlation between adhesion formation and incorporation
At 30 days Strattice showed a significant correlation between the adhesion coverage of the mesh and incorporation of the mesh edge (r=0.681 p=0.030). At 90 days only Surgisis showed a significant correlation coefficient (r=0.828 p= 0.021). In both cases the correlation coefficient indicates that an increase of incorporation is correlated with an increase in adhesion formation.
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