Page 253 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

In ammatory response in a contaminated environment
(Harlan Laboratories, Boxmeer, the Netherlands) weighing 250-350 grams a contaminated environment was created by caecum ligation and puncture(13). Brie y, the caecum was ligated just distally to the ileocaecal valve maintaining the continuity of the bowel and punctured distally to the ligation with an 18-G needle leading to leakage of fecal uids with bacteria into the abdominal cavity to induce peritonitis. After 24 hours the abdomen was re-opened and peritonitis was con rmed by microbiological culture, resulting in a contaminated wound. One of the following meshes (2.5 x 3 cm) was implanted intraperitoneally with 6 transmuscular non-absorbable sutures (5/0 Ethilon, Johnson & Johnson: New Brunswick, New Jersey, United States):
1. Parietene® (polypropylene (PP), Covidien- Sofradim Production, Trevoux, France)
2. Parietene Composite® (PP with an onesided absorbable, hydrophilic collagen-coating, Covidien- Sofradim Production, Trevoux, France)
3. C-Qur® (PP with omega 3-fatty acid-coating and triglycerides, Atrium, Hudson, New York, USA)
4. Sepramesh® (PP, with a hyaluronate-carboxymethylcellulose coating, Bard, New Providence New Jersey, USA)
5. Dualmesh® (expanded polytetra uoroethylene (PTFE), Gore, Flagsta , Arizona, USA)
6. Omyramesh® (condensed PTFE, B Braun, Melsungen, Germany)
7. Strattice® (collagen derived from porcine skin, LifeCell, Branchburg,
New Jersey, USA)
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A control group was included following completely the same protocol, only no mesh was implanted after re-opening the abdomen. After implantation, all rats received one dose of gentamicin (6 mg/kg) intramuscularly. Two to four rats per group died from sepsis(13).
Harvesting
At 28 days and 90 days after implantation of the materials, the animals were euthanized by cardiac cut and a swab was taken to culture bacteria; C-Qur® resulted in 95% (15 out of 16) of the samples positive for bacteria, Dualmesh® 50% (7 out of 15) and Parietene® and Parietene Composite® both 5% (1 out of 15), in the other groups no infections were found. One biopsy per animal was taken from the incorporated mesh with surrounding tissue. In the rats without
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