Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model

Background: In laparoscopic ventral hernia repair a mesh is placed in direct contact with the viscera, often leading to substantial adhesions. In this experimental study the ability of different coated and uncoated meshes to attenuate adhesion formation was examined. Methods: Six commercially availa...

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Veröffentlicht in:British journal of surgery 2009-03, Vol.96 (3), p.305-313
Hauptverfasser: Schreinemacher, M. H. F., Emans, P. J., Gijbels, M. J. J., Greve, J.-W. M., Beets, G. L., Bouvy, N. D.
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container_end_page 313
container_issue 3
container_start_page 305
container_title British journal of surgery
container_volume 96
creator Schreinemacher, M. H. F.
Emans, P. J.
Gijbels, M. J. J.
Greve, J.-W. M.
Beets, G. L.
Bouvy, N. D.
description Background: In laparoscopic ventral hernia repair a mesh is placed in direct contact with the viscera, often leading to substantial adhesions. In this experimental study the ability of different coated and uncoated meshes to attenuate adhesion formation was examined. Methods: Six commercially available meshes were placed intraperitoneally against a closed peritoneum in rats: Prolene® (polypropylene), Timesh® and Ultrapro® (polypropylene composites with titanium and polyglecaprone respectively), Proceed® and Parietex Composite® (polypropylene and polyester meshes coated with a layer of cellulose and collagen respectively) and C‐Qur® (polypropylene mesh coated with a layer of omega‐3 fatty acids). Adhesions and incorporation were evaluated macroscopically and microscopically after 7 and 30 days. Results: Parietex Composite® and C‐Qur® significantly reduced adhesion formation at 7 days' follow‐up compared with all other meshes. By 30 days, this effect had diminished as a significant increase in adhesions together with phagocytosis of the coating was seen for all meshes with layered coatings (Proceed®, Parietex Composite® and C‐Qur®). Incorporation was insufficient for all meshes. Conclusion: The absorbable layers of Parietex Composite® and C‐Qur® reduce adhesion formation to intraperitoneal mesh in the short term, but the effect diminishes and phagocytosis of absorbable coatings may contribute to adhesion formation. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Coatings have short‐term effect only
doi_str_mv 10.1002/bjs.6446
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H. F. ; Emans, P. J. ; Gijbels, M. J. J. ; Greve, J.-W. M. ; Beets, G. L. ; Bouvy, N. D.</creator><creatorcontrib>Schreinemacher, M. H. F. ; Emans, P. J. ; Gijbels, M. J. J. ; Greve, J.-W. M. ; Beets, G. L. ; Bouvy, N. D.</creatorcontrib><description>Background: In laparoscopic ventral hernia repair a mesh is placed in direct contact with the viscera, often leading to substantial adhesions. In this experimental study the ability of different coated and uncoated meshes to attenuate adhesion formation was examined. Methods: Six commercially available meshes were placed intraperitoneally against a closed peritoneum in rats: Prolene® (polypropylene), Timesh® and Ultrapro® (polypropylene composites with titanium and polyglecaprone respectively), Proceed® and Parietex Composite® (polypropylene and polyester meshes coated with a layer of cellulose and collagen respectively) and C‐Qur® (polypropylene mesh coated with a layer of omega‐3 fatty acids). Adhesions and incorporation were evaluated macroscopically and microscopically after 7 and 30 days. Results: Parietex Composite® and C‐Qur® significantly reduced adhesion formation at 7 days' follow‐up compared with all other meshes. By 30 days, this effect had diminished as a significant increase in adhesions together with phagocytosis of the coating was seen for all meshes with layered coatings (Proceed®, Parietex Composite® and C‐Qur®). Incorporation was insufficient for all meshes. Conclusion: The absorbable layers of Parietex Composite® and C‐Qur® reduce adhesion formation to intraperitoneal mesh in the short term, but the effect diminishes and phagocytosis of absorbable coatings may contribute to adhesion formation. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. 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source MEDLINE; Wiley Online Library Journals Frontfile Complete; Oxford University Press Journals All Titles (1996-Current)
subjects Animals
Biological and medical sciences
General aspects
Granulation Tissue - pathology
Medical sciences
Peritoneum - surgery
Rats
Rats, Wistar
Surgical Mesh
Tissue Adhesions - etiology
Tissue Adhesions - pathology
title Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model
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