A randomized controlled experimental study comparing chitosan coated polypropylene mesh and Proceed™ mesh for abdominal wall defect closure

Abstract

BackgroundAbdominal wall defects and hernias are commonly repaired with synthetic or biological materials. Adhesions and recurrences are a common problem. A study was conducted to compare Chitosan coated polypropylene mesh and a polypropylene–polydioxanone composite with oxidized cellulose coating mesh (Proceed™) in repair of abdominal wall defect in a Rabbit hernia model.MethodsA randomized controlled experimental study was done on twelve New Zealand white rabbits. A ventral abdominal defect was created in each of the rabbits. The rabbits were divided into two groups. In one group the defect was repaired with Chitosan coated polypropylene mesh and Proceed mesh™ in the other. The rabbits were operated in two phases. They were followed up at four weeks and twelve weeks respectively after which the rabbits were sacrificed. They were evaluated by open exploration and histopathological examination. Their efficacy in reducing adhesion and ability of remodeling and tissue integration were studied.ResultsThere was no statistical significance in the area of adhesion, the force required to remove the adhesions, tissue integration and remodeling between Chitosan and Proceed™ group. Histological analysis revealed that the inflammatory response, fibrosis, material degradation and remodeling were similar in both the groups. There were no hernias, wound infection or dehiscence in any of the studied animals.ConclusionChitosan coated polypropylene mesh was found to have similar efficacy to Proceed™ mesh. Chitosan coated polypropylene mesh, can act as an anti adhesive barrier when used in the repair of incisional hernias and abdominal wall defects.

Experimental evaluation of intra-abdominal adhesions comparing two different intraperitoneal meshes and the effect of a natural anti-inflammatory product on their formation

“…Then, necroscopy was performed and the macroscopic aspects related to the mesh were observed. The degree of adhesions between the organs and meshes (adhesion scoring), area of adhesion between the surface of the mesh and intraperitoneal structures (adhesion coverage on the mesh surface), and integration of the mesh into the abdominal wall (tissue integration score) were evaluated 11 – 13 ( Tables 1 to 3 ).…”

İntraperitoneal Polipropilen Mesh Kullanımına Bağlı Adezyonların Proflaksisinde Chitin Materyalinin Etkisi

“…Cerrahi uygulamada prostetik polipropilen mesh extraperitoneal veya intraperitoneal olarak yerleştirilebilmektedir. Ancak intraperitoneal olarak uygulanan meshe bağlı batın içi adezyonlar ve seroma formasyonu gibi komplikasyonlar gelişebilmektedir (10). Özellikle batın içi adezyonlar kronik karın ağrısı, infertilite, enterokutanoz fistül, bağırsak obstrüksiyon ve inkanserasyonlarına sebep olmakta ve en önemlisi de gelişen bu komplikasyonlar reoperasyon endikasyonu doğurmaktadır (11)(12)(13)(14)(15).…”

Amniotic Membrane-Coated Polypropylene Mesh for the Repair of Incisional Hernia: An Experimental Study In a Rat Model of Abdominal Wall Defect

“…Recent studies have focused on biomaterials used for reconstruction and prevention methods (7)(8)(9)(10)(11)(12)(13)(14). The amniotic membrane, with a long-term history of usage in tissue reconstruction is one of the promising materials to be used as an antiadhesive (15).…”

“…Particularly in cases with large tissue loss, polypropylene mesh comes in contact with the intraabdominal tissues, causing the adhesions, and leading to intestinal obstruction or fistulas (6). Although many alternative materials and methods for repair of abdominal wall defects were suggested in the literature, such as use of omentum, peritoneum, biological materials, chemicals, stretch films, etc., the ideal material for preventing intraabdominal adhesions is yet to be defined (7)(8)(9)(10)(11)(12)(13)(14). centa, is an avascular matrix with a basement membrane and a monolayer of epithelial cells without major histocompatibility complex antigens (6).…”