Page 289 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

After administration of gentamicin 6 mg/kg intramuscularly (Centrafarm, Etten Leur, the Netherlands), the abdominal wall and skin were separately closed with a running absorbable suture (Sa l 5-0). Buprenor n analgesia 0.05 mg/kg was administrated twice daily on the days animals were operated and the rst day after mesh implantation.
Implanted meshes
The control group received no mesh, and in the mesh groups, 1 of 4 biological meshes was implanted within the peritoneal cavity. Prostheses were prepared according to the manufacturer’s instructions before implantation. Four commercially available biological meshes were implanted:
1. Non-crosslinked porcine dermis Strattice® (LifeCell, Branchburg, NJ)
2. Non-crosslinked porcine submucosa Surgisis® (Cook, Bloomington,
IN)
3. Crosslinked porcine dermis CollaMendFM® (C.R. Bard [Davol,
Inc],Warwick, RI)
4. Crosslinked porcine dermis Permacol® (Covidien, Norwalk, CT).
Measurements
Animals were divided in groups according to implanted mesh and intended time of sacri ce, 90 or 180 days after implantation of the mesh. During the experiment, animals were weighed daily and scored for their wellness using an objective 12-point scoring system during the rst 14 days of the experiment, thereafter once a week(20). In case of severe infectious complication, weight loss of 20% or more, or a wellness score of less than 5 out of 12 points, animals were euthanized before the intended end of the experiment and analyzed together with the surviving animals of the group. On all euthanized and deceased animals necropsy was performed.
During sacri ce, the animals were anaesthetized with iso urane and O2 inhalation; the abdomen was shaved, disinfected, and opened through a U-shaped incision extending laterally and caudally to the mesh. Macroscopically, mesh infection was de ned as the presence of abscesses of the mesh. Parts of the mesh were cultured for microbiological evaluation. In all mesh groups, mesh surface and coverage of the mesh surface with adhesions were scored using a grid placed over the mesh, dividing it into 30 equal squares and facilitating accurate estimation of adhesion formation. Tenacity
14
Infection susceptibility of biological meshes
287