Biomaterial Implants in Abdominal Wall Hernia Repair: A Review on the Importance of the Peritoneal Interface

Gómez-Gil, Verónica; Pascual, Gemma; Bellón, Juan M.

doi:10.3390/pr7020105

Cited by 23 publications

(20 citation statements)

References 117 publications

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“…Abdominal wall hernia is the result of abdominal wall muscle or connective tissue weakness that allows visceral organs to herniate through. 1 Several prosthetic biomaterial-based devices for hernia repair are commercially available, while more innovative and clinically efficient ones are under investigation. 1 Among them, polypropylene (PP)-based fabrics are largely employed and PP meshes have been accepted for a long time as a standard element for abdominal hernia repair.…”

Section: Introductionmentioning

confidence: 99%

“…1 Several prosthetic biomaterial-based devices for hernia repair are commercially available, while more innovative and clinically efficient ones are under investigation. 1 Among them, polypropylene (PP)-based fabrics are largely employed and PP meshes have been accepted for a long time as a standard element for abdominal hernia repair. 2 These meshes are pliable, well incorporable into adjacent tissues and capable of giving robust mechanical support.…”

Section: Introductionmentioning

confidence: 99%

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Polypropylene mesh for hernia repair with controllable cell adhesion/de-adhesion properties

et al. 2020

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Herein, a versatile bilayer system, composed by a polypropylene (PP) mesh and a covalently bonded poly(N-isopropylacrylamide) (PNIPAAm) hydrogel, is reported. The cell adhesion mechanism was successfully modulated by controlling the architecture of the hydrogel in terms of duration of PNIPAAm grafting time, crosslinker content, and temperature of material exposure in PBS solutions (below and above the LCST of PNIPAAm). The best in vitro results with fibroblast (COS-1) and epithelial (MCF-7) cells was obtained with a mesh modified with a porous iPP-g-PNIPAAm bilayer system, prepared via PNIPAAm grafting for 2 h at the lowest N,N 0 -methylene bis(acrylamide) (MBA) concentration (1 mM). Under these conditions, the detachment of the fibroblast-like cells was 50% lower than that of the control, after 7 days of cell incubation, which represents a high de-adhesion of cells in a short period. Moreover, the whole system showed excellent stability in dry or wet media, proving that the thermosensitive hydrogel was well adhered to the polymer surface, after PP fibre activation by cold plasma. This study provides new insights on the development of anti-adherent meshes for abdominal hernia repair.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Polypropylene mesh for hernia repair with controllable cell adhesion/de-adhesion properties

et al. 2020

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“…Experimental animal models have become vital in the evaluation of abdominal meshes for hernia repair since they allow comparison between different implants placed with same surgical technique. This fact provides information about abdominal mesh performance parameters as integration into the recipient tissue, encapsulation, infection susceptibility, remesothelialization capacity and adhesiogenic potential [51].…”

Section: Discussionmentioning

confidence: 99%

Heterologous Bovine Tunica Albuginea Graft Conserved in Honey as Abdominal Wall Reinforcement in Rats

Medeiros¹,

Ferreira²,

Castañon³

et al. 2020

OJVM

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Complex abdominal wall defects might be challenging for human and veterinary surgeons worldwide. Defects from trauma or congenital causes may lead to hernias development. The introduction of meshes to reinforce hernia repairs has improved surgical outcomes and several synthetic and biologic materials have been used. In this context, biomaterial prosthesis seems to be a satisfactory solution when managing great abdominal wall defects. The aim of the current study is to evaluate the bovine tunica albuginea (BTA) preserved in honey as graft material for rats' abdominal wall reinforcement in incisional herniorrhaphy surgery as well as its viability, cicatrization and integration into the host tissue. Wistar rats were assigned to two main groups: 1) animals (n = 20) underwent median longitudinal laparotomy followed by laparorraphy with suture of the bovine tunica albuginea (BTA) graft as abdominal wall reinforcement; and 2) animals (n = 20) underwent only laparotomy and subsequent laparorrhaphy. Rats were clinically evaluated until euthanasia at post-surgical day 7, 14, 21 and 28. Necropsy and histopathological analysis of abdominal wall fragments were performed to compare groups and subgroups findings. BTA promoted abundant fibrosis, providing resistance and low postoperative complication rates. Besides, animals did not show rejection signs to the implant. In conclusion, BTA preserved in honey is an affordable, easy collection and handling biomaterial for graft, demanding simple surgical implantation technique for abdominal wall repair in rats.

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“…This study underlines how the behavior of a biomaterial can be dramatically modeled by the processing with a polymeric coating. Recent reviews [46][47][48] , claim that an ideal material for abdominal wall reinforcement should be able to be integrated and slowly degraded while providing a matrix to native tissue growth. The ideal mesh should also show low encapsulation phenomena, low adhesiogenic potential, resistance to infections and capacity of remesothelialization.…”

Section: Discussionmentioning

confidence: 99%

Bridging repair of the abdominal wall in a rat experimental model. Comparison between uncoated and polyethylene oxide-coated equine pericardium meshes

Pasculli

Gurrado

Luca

et al. 2020

Sci Rep

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Biological meshes improve the outcome of incisional hernia repairs in infected fields but often lead to recurrence after bridging techniques. Sixty male Wistar rats undergoing the excision of an abdominal wall portion and bridging mesh repair were randomised in two groups: Group A (n = 30) using the uncoated equine pericardium mesh; Group B (n = 30) using the polyethylene oxide (PEO)-coated one. No deaths were observed during treatment. Shrinkage was significantly less common in A than in B (3% vs 53%, P < 0.001). Adhesions were the most common complication and resulted significantly higher after 90 days in B than in A (90% vs 30%, P < 0.01). Microscopic examination revealed significantly (p < 0.05) higher mesh integrity, fibrosis and calcification in B compared to A. The enzymatic degradation, as assessed with Raman spectroscopy and enzyme stability test, affected A more than B. the peo-coated equine pericardium mesh showed higher resistance to biodegradation compared to the uncoated one. Understanding the changes of these prostheses in a surgical setting may help to optimize the peo-coating in designing new biomaterials for the bridging repair of the abdominal wall. Incisional hernia affects 10-20% of laparotomies and represents the most common long-term complication after abdominal surgery 1-3. Since their first description by Usher et al. in 1985 4 , synthetic prostheses significantly reduced recurrence rate after the first incisional hernia repair, from more than 20% to less than 10% 5,6. Nevertheless, they are commonly contraindicated in situations in which the exposure to any additional bacterial burden constitutes an excessive risk of surgical site infection 7,8. According to the Ventral Hernia Working Group (VHWG), incisional hernias which are at high risk of surgical site occurrences, because of comorbidities or contamination/infection of the operative field, should be treated using biological meshes; this should also be recommended in those cases in which the complete rectus closure is not possible and bridging technique is unavoidable 9. Although some controversies arose about the influence of technique in determining the surgical site occurrences 10 , and other authors designed and validated other scores 11,12 , VHWG recommendations appear to be still the most reliable guidelines available in the

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Biomaterial Implants in Abdominal Wall Hernia Repair: A Review on the Importance of the Peritoneal Interface

Cited by 23 publications

References 117 publications

Polypropylene mesh for hernia repair with controllable cell adhesion/de-adhesion properties

Polypropylene mesh for hernia repair with controllable cell adhesion/de-adhesion properties

Heterologous Bovine Tunica Albuginea Graft Conserved in Honey as Abdominal Wall Reinforcement in Rats

Bridging repair of the abdominal wall in a rat experimental model. Comparison between uncoated and polyethylene oxide-coated equine pericardium meshes

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