Prophylactic Adhesion with Three New Composite Mesh for Abdominal Wall Reconstruction in A Rat Model_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DING Guofei ¹ , TIAN Wen ¹ , YAO Jing ² , LI Jia ¹ , ZHENG Yajie ¹ , YANG Song. ¹

1.Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China;;
2.Department of General Surgery, The First Hospital Affiliated to PLA General Hospital, Beijing 100857, China;

Corresponding author：

Keywords：

Abdominal defect; Absorbable material; Rat

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ObjectiveTo assess whether using three new types of domestic absorbable anti-adhesive coatings could prevent adhesion to prosthetic meshes. MethodsA rat model of 1 cm-diameter defect in the muscular abdominal wall was made, and a 1.5 cm-diameter mesh was fixed intraperitoneally to cover the defect. One hundred and twenty Wistar rats were randomly divided into four groups: polypropylene (PP)+polylactide-co-caprolactone (PLC) mesh group, PP+hyaluronic acid (HA)/PLC mesh group, PP+collagen/PLC mesh group, and PP+expanded polytetrafluoroethylene (ePTFE) mesh group. Five rats were executed on day 30, 60, 90, and 180 respectively after operation, adhesions were assessed according to Nair criteria and wound healing was studied by microscopy histologically. ResultsThe mean adhesion score of the PP+collagen/PLC mesh group was significantly lower than that of the PP+ePTFE mesh group on day 30, 60, 90, and 180 after operation (P lt;0.05). The mean adhesion score of the PP+PLC mesh group or PP+HA/PLC mesh group were the same as the PP+ePTFE mesh group at the same time (P gt;0.05). No infections occurred, and occurrence of hernia was not found. ConclusionsMeshes with domestic absorbable coating can significantly reduce adhesion to mesh surface, especially with collagen and PLC coating. Meanwhile they are domestic, the costs are much lower, so the common people can afford to use. They have a good clinical prospect.

Citation： DING Guofei,TIAN Wen,YAO Jing,LI Jia,ZHENG Yajie,YANG Song.. Prophylactic Adhesion with Three New Composite Mesh for Abdominal Wall Reconstruction in A Rat Model. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(10): 1049-1053. doi: Copy

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14.	李基业. 疝修补材料类型及有关并发症 [J]. 临床外科杂志, 2006, 11(11): 687689.
15.	凌沛学, 管华诗. 透明质酸及其衍生物防粘连的研究与应用 [J]. 中国药学杂志, 2005, 40(20): 15271530.
16.	Chen WY, Abatangelo G. Functions of hyaluronan in wound repair [J]. Wound Repair Regen, 1999, 7(2): 7989.
17.	张仲文, 徐莘香, 周莉, 等. 聚己内酯/聚乳酸薄膜防治肌腱粘连的实验研究 [J]. 中华骨科杂志, 1998, 11(11): 692694.
18.	张广明. 生物可降解聚乳酸己内酯无规共聚物输尿管支架管的制备及实验研究 [D]. 四川大学, 2006: 1520.
19.	Kaleya RN. Evaluation of implant/host tissue interactions following intraperitoneal implantation of porcine dermal collagen prosthesis in the rat [J]. Springer Paris, 2005, 3(9): 269276.
20.	PetterPuchner AH, Fortelny RH, Glaser KS, et al. Collagen implants in inguinal and ventral hernia repair [J]. J Invest Surg, 2010, 23(5): 280284.
21.	Parker DM, Armstrong PJ, Frizzi JD, et al. Porcine dermal collagen (permacol) for abdominal wall reconstruction [J]. Curr Surg, 2006, 63(4): 255258.
22.	van’t Riet M, de Vos van Steenwijk PJ, Bonthuis F, et al. Prevention of adhesion to prosthetic mesh: comparison of different barriers using an incisional hernia model [J]. Ann Surg, 2003, 237(1): 123128.
23.	Greenawalt KE, Butler TJ, Rowe EA, et al. Evaluation of sepramesh biosurgical composite in a rabbit hernia repair model [J]. J Surg Res, 2000, 94(2): 9298.
24.	Ferrando JM, Vidal J, Armengol M, et al. Experimental evaluation of a new layered prosthesis exhibiting a low tensile modulus of elasticity: longterm integration response within the rat abdominal wall [J]. World J Surg, 2002, 26(4): 409415.

1. Matthews BD, Pratt BL, Pollinger HS, et al. Assessment of adhesion formation to intraabdominal polypropylene mesh and polytetrafluoroethylene mesh [J]. J Surg Res, 2003, 114(2): 126132.
2. 杨晓旭, 鲁建国, 陆美娇, 等. 聚丙烯补片与脱细胞真皮基质补片及传统方法修复战伤性腹壁软组织缺损的比较 [J]. 中国组织工程与临床康复, 2009, 13(29): 56535656.
3. Rohrich RJ, Reagan BJ, Adams WP, et al. Early results of vermilion lip augmentation using acellular allogeneic dermis: an adjunct in facial rejuvenation [J]. Plast Reconstr Surg, 2000, 105(1): 409416.
4. Clayman MA, Clayman LZ. Use of AlloDerm as a barrier to treat chronic Frey’s syndrome [J]. Otolaryngol Head Neck Surg, 2001, 124(6): 687.
5. Choe JM, Kothandapani R, James L, et al. Autologous, cadaveric, and synthetic materials used in sling surgery: comparative biomechanical analysis [J]. Urology, 2001, 58(3): 482486.
6. Silverman RP, Li EN, Holton LH 3rd, et al. Ventral hernia repair using allogenic acellular dermal matrix in a swine model [J]. Hernia, 2004, 8(4): 336342.
7. 中华人民共和国科学技术部. 关于善待实验动物的指导性意见 [Z]. 2007: 20062009.
8. Nair SK, Bhat IK, Aurora AL. Role of proteolytic enzyme in the prevention of postoperative intraperitoneal adhesions [J]. Arch Surg, 1974, 108(6): 849853.
9. Gaertner WB, Bonsack ME, Delaney JP. Visceral adhesions to hernia prostheses [J]. Hernia, 2010, 14(4): 375381.
10. Baptista ML, Bonsack ME, Felemovicius I, et al. Abdominal adhesions to prosthetic mesh evaluated by laparoscopy and electron microscopy [J]. J Am Coll Surg, 2000, 190(3): 271280.
11. Asano T, Takazawa R, Yamato M, et al. Transplantation of an autologous mesothelial cell sheet prepared from tunica vaginalis prevents postoperative adhesions in a canine model [J]. Tissue Eng, 2006, 12(9): 26292637.
12. Bauer JJ, Salky BA, Gelernt IM, et al. Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE) [J]. Ann Surg, 1987, 206(6): 765769.
13. Matthews BD, Pratt BL, Pollinger HS, et al. Assessment of adhesion formation to intraabdominal polypropylene mesh and polytetrafluoroethylene mesh [J]. J Surg Res, 2003, 114(2): 126132.
14. 李基业. 疝修补材料类型及有关并发症 [J]. 临床外科杂志, 2006, 11(11): 687689.
15. 凌沛学, 管华诗. 透明质酸及其衍生物防粘连的研究与应用 [J]. 中国药学杂志, 2005, 40(20): 15271530.
16. Chen WY, Abatangelo G. Functions of hyaluronan in wound repair [J]. Wound Repair Regen, 1999, 7(2): 7989.
17. 张仲文, 徐莘香, 周莉, 等. 聚己内酯/聚乳酸薄膜防治肌腱粘连的实验研究 [J]. 中华骨科杂志, 1998, 11(11): 692694.
18. 张广明. 生物可降解聚乳酸己内酯无规共聚物输尿管支架管的制备及实验研究 [D]. 四川大学, 2006: 1520.
19. Kaleya RN. Evaluation of implant/host tissue interactions following intraperitoneal implantation of porcine dermal collagen prosthesis in the rat [J]. Springer Paris, 2005, 3(9): 269276.
20. PetterPuchner AH, Fortelny RH, Glaser KS, et al. Collagen implants in inguinal and ventral hernia repair [J]. J Invest Surg, 2010, 23(5): 280284.
21. Parker DM, Armstrong PJ, Frizzi JD, et al. Porcine dermal collagen (permacol) for abdominal wall reconstruction [J]. Curr Surg, 2006, 63(4): 255258.
22. van’t Riet M, de Vos van Steenwijk PJ, Bonthuis F, et al. Prevention of adhesion to prosthetic mesh: comparison of different barriers using an incisional hernia model [J]. Ann Surg, 2003, 237(1): 123128.
23. Greenawalt KE, Butler TJ, Rowe EA, et al. Evaluation of sepramesh biosurgical composite in a rabbit hernia repair model [J]. J Surg Res, 2000, 94(2): 9298.
24. Ferrando JM, Vidal J, Armengol M, et al. Experimental evaluation of a new layered prosthesis exhibiting a low tensile modulus of elasticity: longterm integration response within the rat abdominal wall [J]. World J Surg, 2002, 26(4): 409415.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Prophylactic Adhesion with Three New Composite Mesh for Abdominal Wall Reconstruction in A Rat Model

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