Visceral adhesions to hernia prostheses

Abstract

All of the tested prostheses attracted adhesions. Biologic prostheses had smaller areas of coverage compared to synthetic prostheses. Barrier surfaces on synthetic meshes were associated with a much lesser extent of adhesion involvement.

Comparative study of Polypropylene versus Parietex composite®, Vicryl® and Ultrapro® meshes, regarding the formation of intraperitoneal adhesions

“…The Vicryl® mesh was the only one to show reduction of mesh percentage affected by adhesion (p=0.013). This result is in agreement with the results obtained by Gaertner and Dasika 12,17 . In the current study, there was no difference between Parietex composite® and polypropylene in the formation of adhesions (p=0.765).…”

“…The composite meshes -which have the surface facing the viscera made of absorbable and microporous material and the surface facing the muscles made of synthetic macroporous material -are the ones with the best results 20,21 . This composition would be ideal since the biological component of the inner surface would avoid contact between the macroporous part and the abdominal viscera, reducing rates of complications such as adhesions 12 . The macroporous side (>75µm) can also lower the risk of infection since it allows more infiltration of macrophages and neutrophils within the pores, which does not happen in microporous meshes and therefore allows bacterial growth Sixty male rats of the Wistar strain, 100 to 120 days old, were used.…”

“…Burger et al 6 reported that after 10 years of postoperative follow-up, 63% of patients with fascial repair had hernia recurrence, while with the use of meshes, 32% of patients had the same problem. Hence, the use of surgical meshes for correction of abdominal hernias was strengthened due to its lower recurrence rates [6][7][8][9][10][11][12][13][14] . With the advent of laparoscopic surgery and the placement of intraperitoneal meshes, major adhesion formation was highlighted 2,7,[14][15][16][17][18][19] .…”

Inflammatory reaction and tensile strength of the abdominal wall after an implant of polypropylene mesh and polypropylene/poliglecaprone mesh for abdominal wall defect treatment in rats

“…Between 31% and 55% of repairs for hernias without prostheses can lead to a relapse 3,4 . A considerable proportion of patients suffer incarceration or strangulation, requiring emergency abdominal surgery 5 .…”

Abdominal wall healing in incisional hernia using different biomaterials in rabbits

“…repairs made without the use of prostheses may cause recurrence, however the positioning of a polypropylene mesh in direct touching with the intraperitoneal viscera is not recommended since this can form adhesions between viscera and fistulas that occurs in 80-90% of patients 4 .…”