Page 234 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 11
protocol of the experiment was approved by the Ethical Committee on Animal Experimentation of Erasmus University Rotterdam.
Peritonitis model
Rats were anaesthetized by iso urane/oxygen inhalation and received buprenorphine analgesia (0.05 mg/kg subcutaneously). The abdomen was shaved and the skin disinfected with 70 % alcohol, after which the abdominal cavity was opened through a 3-cm midline incision. To induce peritonitis, a caecal ligation and puncture (CLP) model was used(12). The caecum was carefully manipulated outside the abdominal cavity and ligated just distal to the ileocaecal valve with a mono lament non-absorbable suture (4/0 Ethilon®; Ethicon, Johnson & Johnson, Somerville, New Jersey, USA), maintaining the continuity of the bowel. The caecum was punctured distally to the ligation with an 18-G needle. The fascia and skin were closed with a running absorbable suture (5/0 Sa l®; B. Braun, Melsungen, Germany). After 24 h the abdomen was reopened, a culture swab was taken to con rm peritonitis, the necrotic caecum was resected and the abdominal cavity was rinsed with at least 20 ml phosphate-bu ered saline at 37°C. A sterile mesh, measuring 2.5 × 3 cm, was implanted intraperitoneally with three transmuscular nonabsorbable sutures (5/0 Ethilon®) on both sides of the incision in all mesh groups. No mesh was implanted in the control group. After administration of gentamicin (6 mg/kg intramuscularly) the abdominal wall and skin were closed separately with a running absorbable suture (5/0 Sa l®).
Implanted meshes
The rats were divided into eight groups, a control group that received no mesh and groups in which one of the following seven meshes was implanted intraperitoneally:
1. Non-cross-linked collagen (Strattice®; LifeCell, Branchburg, New Jersey, USA)
2. Polypropylene (Parietene®; Sofradim, Trevoux, France; part of Covidien, North Haven, Connecticut, USA)
3. Collagen–polyethyleneglycol–glycerol-coated polypropylene (Parietene Composite®; Sofradim)
4. Omega-3-fatty acid coated polypropylene (C-Qur®; Atrium, Hudson, New York,USA)
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