Critical Analysis of Experimental Model for Study of Adhesions After Incisional Hernias Induced in Rats’ and Repair of Abdominal Wall With Different Biomaterials

Abstract

Background: Adhesions induced by biomaterials experimentally implanted in the abdominal cavity are basically studied by primary repair of different abdominal wall defects or by the correction of incisional hernias previously performed with no precise definition of the most appropriate model. Aim: To describe the adhesions which occur after the development of incisional hernias, before the prosthesis implantation, in an experimental model to study the changes induced by different meshes. Methods: Incisional hernias were performed in 10 rats with hernia orifices of standardized dimensions, obtained by the median incision of the abdominal wall and eversion of the defect edges. Ten days after the procedure adhesions of abdominal structures were found when hernias were repaired with different meshes. Results: The results showed hernia sac well defined in all rats ten days after the initial procedure. Adhesions of the greater omentum occurred in five animals of which two also showed adhesions of small bowel loops besides the omentum, and another two showed liver adhesions as well as the greater omentum, numbers with statistical significance by Student's t test (p<0.05). Conclusion: Although it reproduces the real clinical situation, the choice of experimental model of incisional hernia repair previously induced implies important adhesions, with possible repercussions in the evaluation of the second operation, when different implants of synthetic materials are used.

Stem Cells Hematopoietic Niches and Inflammatory Response to Different Synthetic Prosthesis Implanted in Rat With Incisional Hernias

“…The omentum is formed by a trabecular structure, with blood vessels and adipose tissues, being considered in the available literature an endocrine citocine secretor organ with great functional capacity. It is classified by the structure as a lymphatic reticular organ, rich of arterioles, venules, lymphocytes, mesothelial and endothelial cells, macrophages, monocytes, granulocytes, fibroblasts and adipocytes, possessing angiogenic capacity; stem cells have already been isolated from this tissue, classically associated to abdominal defense against infection or prevention of some complication caused by adhesion induced by surgical manipulation or synthetically material implanted 2 , 3 , 23 , 25 . The omentum was the abdominal structure that most covered the implant material used, being conducive to deployment of megakaryocytes niche identified in the study here described.…”

“…On the 10 th day after the initial operation they were again operated to evaluate incisional hernia and adhesions formed initially 2 , 25 . Undone these adhesions, in each of the five groups one of the following procedures was held: Group 1, simple approximation of the edges of the hernia opening by simple stitches using polyglactin 910 number 5-0 without prosthetic implant; in Group 2 the defect was repaired with hernia polypropylene prosthesis sutured to the edges, an option considered to be reference to the greater inflammatory reaction expected; in Group 3 polypropylene with low weight was employed; in Group 4, polypropylene prosthesis and poliglecaprone; and in Group 5 polypropylene and polyglactin.…”

“…Polypropylene is used since Usher pioneer work in 1958 and several options have been developed aiming at reducing inflammatory response to the implantation, like the diminishing used grammature of used material or the association of a smaller polypropylene framework to other absorbing material. However, triggered inflammatory response is significant, even with different materials available nowadays 2 , 3 , 11 , 16 , 22 , 25 , 29 .…”

Avaliação da eficácia de três marcadores imunoistoquímicos envolvidos nos diferentes tempos da cicatrização da ferida cirúrgica

“…TGF-β1 is probably the most important growth factor in the induction of ACTA2 . They play a key role in wound retraction and in the synthesis and secretion of extracellular matrix proteins 2,9 . The main microfilaments that constitute the cytoplasm of the myofibroblast are actin and/or desmin and proteins associated with smooth muscle cells, being mainly characterized by the presence of the smooth muscle α-actin isoform, typically located in the smooth muscle cells of the blood vesselwalls.…”

Peritoneal Adhesions Type I, Iii and Total Collagen on Polypropylene and Coated Polypropylene Meshes: Experimental Study in Rats

“…The choice of mesh for incisional hernia repair may be a dilemma, since nowadays various types are available 10 , 20 , 24 . Therefore, here was used a mesh already widely chosen in surgical practice, i.e.…”