Evaluation of Seprafilm and Amniotic Membrane as Adhesion Prophylaxis in Mesh Repair of Abdominal Wall Hernia in Rats

Abstract

Introduction: Adhesion formation following abdominal wall hernia repair with prosthetic mesh may lead to intestinal obstruction and enterocutaneous fistula. Physical barriers, namely, human amniotic membrane (HAM) or Seprafilm (Genzyme, Cambridge, Mass., USA), a bio-absorbable, translucent membrane composed of carboxymethylcellulose and hyaluronic acid, have been reported to prevent postsurgical intra-abdominal adhesions. Objective: Evaluating the effect of HAM and Seprafilm in preventing adhesion formation in the rat model of ventral hernia repair with polypropylene mesh (PPM). Material and Methods: Sixty female Sprague-Dawley rats were divided into three groups. A full-thickness abdominal wall defect was created in each animal. Control animals had the PPM sutured into the defect, whereas in the other two groups, either HAM or Seprafilm were laid over the abdominal viscera before the repair with PPM. Half of the animals in each group were sacrificed on the 21st postoperative day. The remaining rats of the same group were re-operated on the 42nd day for investigation and measurement of the adhesion area in relation to the graft area. Results: Direct mesh repair showed 52.8 and 56% area adhesion formation 3 and 6 weeks postoperatively, respectively. The HAM barrier covered with mesh repair demonstrated 0 and 0.96% area adhesion formation, and the Seprafilm-covered mesh repair showed 0 and 0% area adhesion formation 3 and 6 weeks postoperatively, respectively. Uncovered mesh showed a significantly larger adhesion area than both covered mesh (p = 0.001 and 0.001). Both HAM and Seprafilm were equally effective in preventing postoperative adhesions. Conclusions: HAM and Seprafilm proved to be an effective antiadhesive barrier in PPM repair of abdominal wall hernia.

Prevention Of adhesion To prosthetic mesh: Comparison Of Oxidized Generated Cellulose, Polyethylenglycol And Hyalen GF 20 (An Experimental Study)

“…Following open gynecological interventions, this ratio may increase up to 97%. [1][2][3][4][5][6][7] The postoperative adhesions are an important problem for surgeons at reoperation owing to the increased access time into the abdominal cavity, difficulties during exploration and injuries to the adjacent organs. In 1998 in the United States, the cost of treatment for preventing formation of adhesions and complications was 1.6 billion dollars.…”

The role of bovine preserved peritoneum in rats ventral hernia: a histological evaluation

“…Fascia grafts 12 , preserved human dura 13,14,15 and bovine pericardium 16,17,18 are tissues utilized in the experiments and clinical practice. Infrequently, the human hernia sac 19,20 , amniotic membranes combined with non-absorbable synthetic material 21 and extra cellular matrix, as porcine intestinal or dermal collagen, as human acellular dermal 22 , may be presented as options. The bovine parietal peritoneum (BPP), usually extracted from healthy animals, may be presented as an option by supplying a large amount of material in each collect procedure and the processes of preparing and storage are relatively inexpensive.…”

Peritônio bovino conservado na correção de hérnia ventral em ratos: uma alternativa para tela cirúrgica biológica

“…As telas absorvíveis, sintéticas ou biológicas, apresentam vantagens inerentes à sua característica de absorção pelo organismo. Entre as próteses absorvíveis biológicas mais estudadas e utilizadas estão: a dura-máter humana 5,6 , a membrana amniótica humana 7,8 , o saco herniário humano 9,10 , a fáscia-lata humana 11,12 , matrizes extracelulares de colágeno suíno [13][14][15] e o pericárdio de bovinos 16,17 , eqüinos 18 ou caprinos 19 . O pericárdio bovino é uma prótese biológica de uso corrente mas apresenta limitação na extensão do tecido obtido para implante.…”