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Abstract
ABSTRACT Background:Among the various strategies to avoid exaggerated foreign body reaction in the treatment of hernias is the limitation of the amount of polypropylene or the use of absorbable material. Aim:To evaluate the healing of defects in the abdominal wall of rats, comparing microporous polypropylene, macroporous polypropylene and polypropylene/polyglecaprone at the 30º, 60º and 120º postoperative day. Methods:Wistar rats were submitted to defect production in the ventral abdominal wall, with integrity of the parietal peritoneum. Prolene®, Ultrapro® and Bard Soft® meshes were used in the correction of the defect. Nine subgroups of 10 animals were submitted to euthanasia at 30th, 60th and 120th postoperative day. Fragments of the abdominal wall of the animals were submitted to tensiometric analysis. Results:The tensiometry at the 30th postoperative day showed greater resistance of the tissues with Bard Soft® (macroporous mesh) in relation to the tissues with Prolene® (microporous mesh). On the 60th postoperative day Bard Soft® maintained the superior resistance to the tissues comparing to Prolene Mesh®. On the 120th postoperative day the tissues repaired with Ultrapro® (macroporous mesh) proved to be more resistant than the ones by Prolene® (microporous mesh) and Bard Soft® (macroporous mesh). Conclusion:The tissues repaired with macroporous meshes showed greater resistance than with microporous meshes at all stages, and at 120 days postoperative Ultrapro® performed better than the others.
Highlights
The standard procedure for the surgical correction of the incisional hernia is performed with the use of meshes[3,7,12]
The most important concept in the development of hernia surgery in recent years is the use of low weight meshes with large pores
In tissue tensiometry with implanted tissue, it was found that the rupture always occurred outside the suture line of the mesh in the abdominal wall
Summary
The standard procedure for the surgical correction of the incisional hernia is performed with the use of meshes[3,7,12]. The most widely used material is polypropylene which causes rapid acute inflammatory response followed by chronic foreign body reaction that persists for months and years after the surgical procedure. Among the various strategies used to avoid exaggerated foreign body reaction is the limitation of the amount of polypropylene or the use of absorbable material that provides initial resistance and is quickly reabsorbed by reducing local inflammation[14]. Attempts to reduce the amount of foreign body focused on the design of the macropores and the absorbable and nonabsorbable components of the meshes. The new designs promoted the development of the classification of the meshes as high, medium and low weight, respectively values above 80 g/m2, between 50-80 g/m2 or below 50 g/m2. The most important concept in the development of hernia surgery in recent years is the use of low weight meshes with large pores. The Ultrapro® represents a new member in the group of low weight with large pores
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