Treatment of abdominal wall hernia with suture, or polypropylene, or collagen prosthesis.

Diego Paim Carvalho Garcia,Thiago De Almeida Furtado,Pablo Nelson Do Valle Hubner,Andy Petroianu,Clarissa Santos Neto,Luiza Ohasi De Figueiredo,Luiz Ronaldo Alberti

doi:10.1590/s0102-865020160060000002

Abstract

To develop an experimental model for incisional hernias and to compare morphological and functional aspects of hernia repairs by suture, polypropylene mesh and collagen mesh. A defect measuring 7cm x 2cm was created in the anterior abdominal of 28 New Zealand male rabbits, divided into four groups (n = 7): (1) control, (2) suture of the anterior sheath of the rectus abdominal muscle, (3) setting of polypropylene mesh, and (4) setting of collagen mesh. On the 90th postoperative day, the animals were examined to verify the presence of incisional hernia. Samples of abdominal wall and scar were collected for histological study. Incisional hernia was identified in 85.7% of the control group, 57.1% of the suture group, 42.9% of the collagen mesh group, and none in the polypropylene mesh group (p = 0.015). Mesh exposure could be identified in 71.4% of the animals in group 3 and in no animal in group 4 (p = 0.021). The polypropylene mesh is effective in the treatment of abdominal wall defects, causing an intense inflammatory reaction. The collagen mesh is biocompatible, producing a minimal inflammatory reaction, but fails in the treatment of abdominal wall defects.

Highlights

The incisional hernia consists of the protrusion of ofalls, through orifices or abdominal wall, abnormally weakened by congenital defects or traumas and surgical procedures
The incisional hernia was identified in 100% of the rabbits from the control group, in 57.1% from the suture repair group, and in 42.9% from the biological mesh group (Table 1)
Mesh exposure could be identified in 71.4% of the animals from group 3 and in no animal from group 4 (p=0.021)

Summary

Introduction

The incisional hernia consists of the protrusion of ofalls, through orifices or abdominal wall, abnormally weakened by congenital defects or traumas and surgical procedures. The use of prostheses in fascial-defect repair has resulted in reduction of the recurrence of abdominal wall hernias[2,3]. Recent data from a study on prospective, random, and controlled suture repair versus prosthetic implant revealed much better results when mesh was used[4]. The setting of the mesh allows for the stress-free restoration of the structural integrity of the abdominal wall. Advantages for the use of mesh include its availability, non-dependence on integrity, as well as the resistance of the patient’s tissues[3,7]. The development of substances combining non-absorbable, absorbable material and biological materials is of utmost importance in an attempt to reduce the complications related to the mesh and to restore the functions of the abdominal wall[11,12]

Methods

Results

Conclusion