The Effect of Different Temporary Abdominal Closure Materials on the Growth of Granulation Tissue After the Open Abdomen

Abstract

Temporary abdominal closure (TAC) is often performed after an open abdomen to prevent postoperative complications. Reducing the time of TAC and performing a skin grafting as early as possible would improve the outcome of open abdomen. This study was designed to evaluate the effects of different TAC materials and topically applied exogenous growth factors on the growth of granulation tissue covered on the wound areas after the open abdomen. Healthy Sprague-Dawley rats were randomly assigned to four groups of six animals each. Twenty-four hours after induction of peritonitis and intra-abdominal hypertension by intraperitoneal injection of nitrogen, relaparotomies were done. The abdomen was then closed with polyethylene sheet or polypropylene mesh plus growth factor (or not). On the seventh day after TAC surgery, TAC materials were removed, and granulation tissue on the wound surface was assessed microscopically. Microvascular densities, thickness of granulation tissue, and fibroblast counts were also measured. Microvascular densities, thickness of granulation tissue, and fibroblast counts were the highest for polypropylene mesh closure plus recombinant bovine basic fibroblast growth factor (rbFGF) followed by polypropylene mesh plus recombinant human growth hormone (rhGH) and polypropylene mesh alone, with polyethylene sheet alone being the least. Polypropylene mesh could promote the growth of granulation tissue after the open abdomen. Topical application of rhGH or rbFGF further hastens the process, with the effect of rbFGF being the greatest.