Abstract
To evaluate the healing process of a defect in the ventral abdominal wall of rats, comparing the polypropylene and polypropylene/poliglecaprone meshes on the 30(th) and 60(th) postoperative day. Thirty two Wistar rats were submitted to a ventral abdominal wall defect, with integrity of the parietal peritoneum. In the repair, were used polypropylene (group A) and polypropylene/poliglecaprone (group B) meshes. The groups were subdivided into four subgroups of eight animals euthanized on the 30(th) (A30 and B30) and 60(th) postoperative day (A60 and B60). Fragments of the abdominal wall of the animals were submitted to macroscopic, tensiometric and histological evaluations. The tensiometry on subgroup A30 showed a mean average break point of 0.78 MPa and in A60, 0.66 Mpa. In subgroup B30 it was 0.84 MPa and in B60, 1.27 Mpa. The score of the inflammatory process showed subacute phase on A30 and B30 sub-groups and chronic inflammatory process in subgroups A30 and 60B. The tensile strength was higher on the wall repaired by polypropylene/poliglecaprone mesh in the 60(th) post-operative day. Histology showed higher concentration of fibrosis on the surface of the polypropylene mesh with a tendency to encapsulation. In polypropylene/poliglecaprone subgroups the histology showed higher concentration of fibrosis on the surface of mesh filaments.
Highlights
Incisional hernia is a complication that can be found among all surgeons when performing abdominal surgery
The prevalence of incisional hernia after laparotomy is 5% to 10%, and when ventral hernias are repaired without the use of meshes, recurrences are above 46%
The polyester or polypropylene ones when used in closure of abdominal wall defects induce the formation of strong scar tissue, helping hernia correction[2]
Summary
Incisional hernia is a complication that can be found among all surgeons when performing abdominal surgery. The prevalence of incisional hernia after laparotomy is 5% to 10%, and when ventral hernias are repaired without the use of meshes, recurrences are above 46%. It is reduced to less than 10% when meshes are used[1]. The polyester or polypropylene ones when used in closure of abdominal wall defects induce the formation of strong scar tissue, helping hernia correction[2]. Mesh utilization for hernia correction was intensified since the 1950s, after the preliminary studies of Usher and Wallace[3]. It has been proven to increase strength of the wall, but the high porosity of the polypropylene mesh induces an intense inflammatory reaction with fibrosis, which reduces the elasticity of the wall[4]
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