Page 213 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

A recognizable di erence exists between the meshes in performance characteristics such as cellular response, strength, biodegradability, and susceptibility to infection(19). Biologic meshes are thought to induce fewer adhesions because of increased “biocompatibility” and less foreign body reaction(16)]. On the other hand, these characteristics may result in less incorporation into the abdominal wall(19). Furthermore, some biologic 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 bene ts of a biologic sca old(20, 21).
This study aimed to help in the selection of the appropriate prosthesis from the wide choice of available hernia reinforcement materials. Therefore, we compared a commonly used synthetic mesh and a composite mesh with one cross-linked and two non-cross-linked biologic meshes in intraperitoneal 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 ve groups corresponding with the ve 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.
Animals studied
Male inbred rats of the Wistar strain weighing 340–390 g were obtained from a licensed breeder in Harlan, The Netherlands and given 2 weeks to become customized to laboratory conditions before the start of the study. The animals were bred under speci c pathogen-free conditions, kept under standard laboratory conditions in individually ventilated cages (temperature, 20–24 °C; relative humidity, 50–60 %; 12-h light and 12-h dark cycles), and fed with
10
Biological mesh in hernia repair
211