Page 115 - Postoperative Intra-Abdominal Adhesions- New insights in prevention and consequences

Biological and synthetic meshes in ventral hernia repair
These observations suggest that Permacol mesh placement results in a foreign body reaction comparable with that of synthetic meshes, resulting in formation of a fibrotic capsule rather than tissue regeneration. An explanation may be found in the chemical cross- linking process. The aim of this process is to increase the strength of the scaffold and to restrain the in vivo degradation process. A disadvantage may be that cross-linking results in biocompatibility, possibly leading to more adhesion formation. Therefore, based on results in this study, non-cross-linked mesh should be preferred to prevent strong adhesion formation.
We conclude from this study that biological meshes are not necessarily
superior to synthetic meshes with regard to adhesion formation, incorporation and shrinkage. Our data confirms the outcome of earlier
studies in which composite meshes showed clear advantages in comparison to other meshes on the market [38, 39]. The difference in 6 our results between 30 and 90 days appears to be highly significant and
should lead to careful interpretation of short-term experimental results.
Acknowledgements:
This study was financially supported by Lifecell, KCI, Branchburg, New Jersey. The manufacturer of Strattice mesh was not involved in the study design, analysis of results, or preparation of the manuscript. We emphasize that no employee of Lifecell was present during the study and that the scoring was done by blinded and completely independent observers. The authors thank those researchers whose work is referred to in this thesis. In turn, it is the authors’ hope that this report will prove useful to others in further research on the use of biologic meshes for ventral hernia repair.
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