Evaluation of In Vivo Adhesion Properties of New Generation Polyglactin, Oxidized Regenerated Cellulose and Chitosan-Based Meshes for Hernia Surgery

Abstract

IntroductionComposite meshes coated with anti-adhesive barriers have been developed by taking advantage of the robustness of polypropylene meshes for use in hernia repair. We aimed to evaluate the effects of composite meshes containing polyglactin, polycaprolactone, oxidized regenerated cellulose and chitosan on the adhesion formation. MethodsForty-two Sprague Dawley male rats were divided into six groups of seven rats according to the content of the meshes used. A defect was created on the right abdominal wall of the rats and an oval composite mesh of 2 cm in diameter was placed over the defect and fixed. The rats were sacrificed under anesthesia on the 7th postoperative day. Macroscopic and histopathological examination was performed and the incorporation of the mesh with the abdominal wall and the presence of intraabdominal adhesions were evaluated. ResultsWhen the macroscopic findings of the rats were evaluated, there was a statistically significant difference between the rat groups in terms of the distribution of peritoneal adhesion scores (p<0.05). There was no statistically significant difference between the rat groups in terms of the distribution of inflammation, fibrosis and macrophage levels (p>0.05). ConclusionIt was evaluated that the development of intraabdominal adhesion and the strength of adhesion decreased when biocompatible adhesion barriers with anti-adhesive properties such as oxidized regenerated cellulose and chitosan were used in the structure of composite meshes used in hernia repair. Hemostatic and antibacterial properties of these substances are promising to create the ideal mesh.

A Review of Advanced Abdominal Wall Hernia Patch Materials

“…[61] Common derivatives include carboxymethylcellulose (CMC), [123][124][125] methylcellulose (MC), [97] and oxidized regenerated cellulose (ORC). [126][127][128] In recent years, the application of bacterial cellulose (BC) in the fabrication of advanced AWHPMs has been significantly attractive. [61,129,130] BC produced by bacteria (e.g., Komagataeibacter xylinus X-2 [59] ) has a linear structure comprised of beta-1,4-glucan chains.…”

“…[101] Widely employed in tissue recovery applications, [133] CTS owes its popularity to its extraordinary antibacterial properties [99,101] and biodegradability. [76] Several studies have demonstrated inadequate blood compatibility of CTS/CTS-based materials used in AWR, [128,134,135] leading to acute and chronic inflammation, [76,99] and hindering the wound healing process. [99] Additionally, CT and its derivatives suffer from hydrophobicity and restricted solubility in water within the context of AW application.…”