Page 288 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 14
biological meshes in a contaminated environment in a model of abdominal wall repair in the rat.
Methods
Animals
Experimental protocols were approved by the Ethical Committee on Animal Experimentation of the Erasmus University Rotterdam. Ninety male rats of the outbred Wistar strain were obtained from a licensed breeder (Harlan, the Netherlands) and accustomed to laboratory conditions 2 weeks before the start of the experiment. The animals were bred under speci c pathogen-free conditions, were kept under standard laboratory conditions in individually ventilated cages in pairs, and had free access to standard rat chow and water throughout the experiment.
Peritonitis model
Rats were anaesthetized with iso urane and O2 inhalation (Pharmachemie, Haarlem, the Netherlands) and received buprenor n analgesia 0.05 mg/ kg subcutaneously (Reckitt Benckiser Healthcare (UK) Limited, Kingston upon Thames, United Kingdom). Procedures were performed under aseptic conditions. The abdomen was shaved and the skin disinfected with 70% alcohol, after which the abdominal cavity was opened through a 3-cm midline incision through the skin and linea alba. To induce peritonitis, the cecal ligation puncture model was performed in all rats(18, 19). The cecum was carefully manipulated outside the abdominal cavity and ligated just distal to the ileocecal valve with a mono lament non-absorbable nylon suture (Ethilon 4-0; Ethicon, Somerville, NJ), maintaining the continuity of the bowel. Distally, the cecum was punctured once with an 18-ga needle. The fascia and the skin were closed with running absorbable polyglycolic acid sutures (Sa l 5-0; B Braun, Melsungen, Germany). After 24 hours of recovery, the animals were re-anesthetized, the abdomen was reopened, a culture swab taken to con rm peritonitis, the necrotic cecum 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 x 3 cm, was implanted intraperitoneally with 6 transmuscular non-absorbable sutures (Ethilon 5-0) in all mesh groups. In the control group no mesh was implanted.
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