Page 298 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 14
between rats and humans. Furthermore, the chosen intraperitoneal placement of the mesh could have in uenced incorporation of the mesh in the abdominal wall because the mesothelial layer of the peritoneum is less vascularized than the retromuscular space(55). On the other hand, closure of the peritoneal layer is often de cient when attempting sublay positioning of the mesh in humans, making the used model clinically relevant.
Conclusions
In conclusion, this experiment demonstrates a high infection rate and increased adhesion formation of crosslinked biological meshes (Permacol and CollaMendFM). Resistance to infection of non-crosslinked Strattice could allow implantation in the contaminated environment. However, the poor incorporation of all biological meshes and complete degradation of Surgisis makes long-term biomechanical strength of hernia repair questionable. Implantation of biological prostheses could be a valid choice in staged contaminated abdominal wall repair. Prevention of mesh infection associated with high costs for intensive care treatment, reoperation, and prolonged hospital stay might justify the high costs of a biological mesh.
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