Reconstruction Of Abdominal Wall Defects Research Articles

Comparative study between anterior component separation and transversus abodominis muscle release in reconstruction of abdominal wall defect

Background Ventral hernia repair is one of the most common operations performed today, yet when complex and huge, it presents a true challenge for the surgical team. Patients and methods Based on our prospective randomized study, a few preliminary conclusions can be drawn. There was no significant difference in most outcomes between patients who underwent repair with the Transversus abdominis muscle release (TAR) technique or with perforator-preserving component separation when using the same type of polyprolene mesh and in the same retro-muscular position. Results The mean hospital stay was slightly higher when performing the TAR technique (5.2 days), while it was 4.3 days after the perforator-preserving approach. There is a nearly equal incidence of postoperative wound complications and also no statistically significant difference in the rate of recurrence between the two methods, and the rate of wound complications and recurrence is significantly lower than the classic, commonly used method of anterior component separation. Conclusion After this comparative study, both the TAR and anterior component separation (perforator preserving) techniques are effective and reliable methods in experienced hands, and if there is no special indication for one of them, the choice between both should depend on surgeon preference and experience.

Bioactive microgel-coated electrospun membrane with cell-instructive interfaces and topology for abdominal wall defect repair.

Current mesh materials used for the clinical treatment of abdominal defects struggle to balance mechanical properties and bioactivity to support tissue remodeling. Therefore, a bioactive microgel-coated electrospinning membrane was designed with the superiority of cell-instructive topology in guiding cell behavior and function for abdominal wall defect reconstruction. The electrostatic spinning technique was employed to prepare a bioabsorbable PLCL fiber membrane with an effective mechanical support. Additionally, decellularized matrix (dECM)-derived bioactive microgels were further coated on the fiber membrane through co-precipitation with dopamine, which was expected to endow cell-instructive hydrophilic interfaces and topological morphologies for cell adhesion. Moreover, the introduction of the dECM into the microgel promoted the myogenic proliferation and differentiation of C2C12 cells. Subsequently, in vivo experiments using a rat abdominal wall defect model demonstrated that the bioactive microgel coating significantly contributed to the reconstruction of intact abdominal wall structures, highlighting its potential for clinical application in promoting the repair of soft tissue defects associated with abdominal wall damage. This study presented an effective mesh material for facilitating the reconstruction of abdominal wall defects and contributed novel design concepts for the surface modification of scaffolds with cell-instructive interfaces and topology.

Subtotal Thigh Flap for Large Abdominal Wall Defect Reconstruction in Patient With Recurrent Dermatofibrosarcoma Protuberans: A Case Report and Literature Review.

Harvesting an adequate-sized flap is challenging for reconstructing large defects on the abdominal wall. A subtotal thigh flap would be one of the choices as it provides a well-vascularized large flap with muscle components. Moreover, dermatofibrosarcoma protuberans (DFSP) is a low-grade dermal neoplasm with a high recurrence rate. There is still no consensus on the extent of resection to prevent a recurrence. We present a case of a patient who underwent the reconstruction of a large abdominal wall defect with a subtotal thigh flap after the resection of recurrent DFSP. A 59-year-old man killed from a recurrent huge mass in the lower abdomen with an invasion of the small intestine. His baseline characteristics and records of operations, medications, and outcomes were reviewed. After tumor excision, a 28 × 30-cm subtotal thigh flap was harvested from his left thigh to reconstruct the abdominal defect. A microvascular anastomosis with left deep inferior epigastric vessels was made eventually. The flap was in good condition, and the donor site was covered with a split-thickness skin graft. Subtotal thigh flap may be considered for large abdominal wall defect reconstruction as it allows good perfusion of relatively large skin paddles compared with other free flaps. Also, patients with DFSP need definite margin-free resection and close follow-up to prevent a recurrence.

Reconstruction following full-thickness excision of abdominal wall tumors: A prospective observational study conducted in a tertiary care Government Hospital in Eastern India

Background: Reconstruction of abdominal wall defects following full-thickness excision of large tumors (primary or metastatic) has always been a challenge for the treating surgeon. A number of reconstructive techniques have been described in the literature, including different types of meshes, flaps, and component separation techniques (anterior and amp; posterior), with varying results. We conducted a prospective observational study of our three-layer technique of abdominal wall closure at Medical College Hospital, Kolkata, to assess the long-time success of the procedure, especially in terms of hernia rates. Aims and Objectives: Reconstruction of abdominal wall defects following full-thickness excision of large tumors (primary or metastatic) has challenged surgeons for long, with several reconstructive techniques being described, with varying results. We conducted a prospective observational study of our three-layer technique of abdominal wall closure at Medical College Hospital, Kolkata, to assess the long-time success of our procedure, especially in terms of hernia rates. Materials and Methods: Thirteen patients with abdominal wall primary and isolated metastatic tumors were included from January 2017 to January 2022 with follow-up period from 8 to 60 months. Tumors were dermatofibrosarcoma protuberans, sarcomas, desmoid tumors, and two abdominal wall metastases. All patients in our study underwent computed tomography scan, core needle biopsy, and immunohistochemistry for better surgical planning. Results: Eight patients were male and five were female with mean age of 39 years and mean defect size of 10 cm. Polypropylene mesh was used, size varying from 15×15 to 30×30 cm with average operative time of 210 min. Post-operative superficial wound infection in 2 (15%), partial flap necrosis in 1 (7.6%), and tumor recurrence in one patient (7.6%) were seen. Conclusion: For closure of such large abdominal wall defects, our three-layer reconstructive technique has shown good results in terms of zero hernia rates. We recommend our method of closure, where affordability of biological meshes, availability of expensive meshes, accessibility to plastic and reconstructive surgeons or non-acquaintance with complex closure techniques are present.

Reconstruction of Abdominal Wall Defect with Composite Scaffold of 3D Printed ADM/PLA in a Rat Model.

Abdominal wall defects are a frequently occurring condition in surgical practice. The most important are material structure and biocompatibility. In this study, polylactic acid (PLA) mesh composited with a 3D printing of acellular dermal matrix (ADM) material is used to repair abdominal wall defects. The results show that the adhesion score of ADM/PLA composite scaffolds is smaller than PLA meshes. Immunohistochemical assessment reveals that the ADM/PLA composite scaffold can effectively reduce the inflammatory response at the contact surface between the meshes and the abdominal organs. And the ADM/PLA composite scaffold can effectively reduce the expression levels of the inflammation-related factors IL-6 and IL-10. In addition, the ADM/PLA composite scaffold repair is rich in the expression levels of tissue regeneration-related factors vascular endothelial growth factor and transforming growth factor β. Thus, ADM/PLA composite scaffolds can effectively reduce surrounding inflammation to effectively promote the repair of abdominal wall defects.

OC-010 RESULTS OF PREHABILITATION IN PATIENTS WITH COMPLEX ABDOMINAL WALL DEFECTS

Abstract Aim Complex abdominal wall reconstruction (CAWR) remains challenging, even in expert centers. Complication rates are still high, especially in patients with modifiable risk factors (MRF) like obesity, smoking, or diabetes. For several surgical trajectories, prehabilitation of MRF has shown to reduce complication rate. The purpose of this study was to determine the effect of prehabilitation in high risk MRF patients undergoing CAWR on convalescence. Materials and Methods A retrospective cohort study was performed in an expert hernia center. All patients undergoing complex abdominal wall defect reconstruction (hernia width beyond 10 cm, contaminated surgical field or relevant comorbidities) between 2015 and 2019 were included. Each patient was discussed in a multidisciplinary meeting, after which those referred for prehabilitation were compared to those with direct approval. Focus of a supervised preconditioning program could be weight loss, smoking cessation, physical training or a combination. Results From 418 patients discussed, 259 patients underwent CAWR and were included for analysis, of which 126 (49%) underwent prehabilitation. Hernia and intra-operative characteristics were comparable. BMI (28vs30, p<0.001), HbA1c (41vs48, p=0.014), active smokers (4%vs25%, p<0.001) and risk factors (14%vs48%, p<0.001) were higher in the latter group. After prehabilitation, characteristics were comparable. There were no significant differences in postoperative outcome measures (hospital stay 6[5–8]vs6[5–8] days, p=0.908, complication rate 39%vs33%, p=0.190). Conclusions Prehabilitation of modifiable risk factors is profitable in patients planned for CAWR. Subsequent postoperative results were comparable to those without or with less risk factors: prehabilitation downgrades high risk patients to low risk patients. Prospective research is advised.

Challenging Management of Large Aggressive Fibromatosis of the Anterior Abdominal Wall: A Case Report

Aggressive fibromatosis is a rare and benign tumor of soft tissues, locally invasive but never metastasizes. This proliferation arises in musculoaponeurotic structures. It is more common in young fertile women due to hormonal influences. Radical resection with free margins is the key to an effective outcome. We present here the case of a 47-year-old woman, without medical history, who was referred to our hospital for a painful swelling of the left iliac fossa, diagnosed with aggressive fibromatosis of the anterior abdominal wall based on radiological and histological findings. She underwent an excision of the mass with free margins followed by reconstruction of the musculo-fascial defect. After a follow-up of 12 months, there was no evidence of recurrence. Management of aggressive fibromatosis remains a challenge for surgeons. Complete excision of the tumor followed by reconstruction of abdominal wall defect is the first choice of treatment.

Abdominal Wall Reconstruction Using Pedicled Antero Lateral Thigh Flap.

Reconstructing abdominal wall defects has been a difficult task for surgeons. The abdominal wall defects range from defects of only soft tissue to full thickness defects including all the three layers of the abdomen. Only soft tissue defects are commonly caused by peritonitis and laparotomies, and full thickness defects can occur from en bloc resection of tumours as well as trauma. Treatment options available include component separation, partition technique, flap coverage, and more recently acellular dermal matrix. This retrospective study done between 2016 and 2020 where 20 patients were operated for abdominal wall defect using Pedicled ALT flap in the Department of Plastic and Reconstructive Surgery, Sawai Man Singh Hospital, Jaipur, Rajasthan, India. The study consisted of total 20 patients, 14 males and 6 females. Eight patients were post electric burn, 5 patients had suffered trauma, 4 patients underwent resection of abdominal wall tumour and 3 patients were post laparotomy for peritonitis. Mean age of patients was 48 years (range from 36 to 62 years). Mean fascia defect size was 14.2 cm (range 12.2 to 16.4 cm). Mean operative time was 170 minutes (range from 140 minutes to 220 minutes). Postoperative hospital stay ranged from 8 days to 24 days (mean- 12 days). Pedicled ALT flap has expanded the armamentarium of plastic surgeons for reconstruction of abdominal wall defects.

The external oblique muscle flap technique for the reconstruction of abdominal wall defects

PurposeSeveral modifications to the anterior component separation technique (ACST) have been reported to facilitate the closure of abdominal wall defects. In this study, the external oblique (EO) muscle flap for modified ACST during major abdominal wall defect reconstructions has been described. MethodsA retrospective review of consecutive patients undergoing modified ACST was conducted. The clinical data were collected and retrospectively analyzed. ResultsAmong the 36 patients admitted to our hospital from December 2014 to December 2020, 9 cases had rectus abdominis tumors, 1 case had rectus abdominis trauma, and 26 cases had incisional hernias. The average age was 61.17 ± 13.76 years, and the mean BMI was 24.25 ± 3.18 kg/m2. The average width of the defect was 14.33 ± 2.90 cm. Unilateral EO muscle flap technique was used to reconstruct the abdominal wall. 3 cases of surgical site infection (8.3%), 4 cases of grade III or IV seroma (11.1%) and 2 cases of intestinal obstruction (5.5%)were reported postoperatively. Ischemic necrosis of the abdominal EO muscle flap, incision dehiscence, intestinal fistula, or other complications were not observed. 1 case of incisional hernia recurrence (2.8%) was reported. Recurrence of tumors or abdominal wall bulging were not noted during the follow-up period of 32.53 ± 14.21 months. ConclutionsThe EO muscle flap technique is associated with low postoperative morbidity and recurrence rate, which approves it a reliable technique for selected groups of patients. Further research are needed to confirm the effectiveness of this technique.

Abdominal Wall Reconstruction Using Omental Flap with Mesh Repair following Resection of Aggressive Abdominal Wall Neoplasms

Background: Resection of large anterior abdominal wall tumors causes large full-thickness abdominal wall defects, and the repair of these defects remains a challenging point. Methods: Between July 2016 and February 2021, we retrospectively reviewed the internal database registry of the Oncology Center, Mansoura University (OCMU), Egypt, for patients with large abdominal wall defects after abdominal wall tumors resection and repair with omental flaps and synthetic polypropylene (PP) mesh. Thirty-two patients met the inclusion criteria. They were analyzed for demographics and operative data including defect size, mesh size, intra-abdominal tumor extension, and postoperative outcomes and complications. Results: Thirty-Two patients with abdominal wall neoplasm underwent local resection in our center and the defect was closed with an omental flap and PP mesh. The mean operative time was 143.75 ± 30.77 min. The mean size of the abdominal wall defect was 50.8 cm² (range: 25–90 cm²). The meshes used in reconstruction had a mean size of 89.5 cm² (range: 55–130 cm²). The median follow-up period of the patients was 13.5 months (range: 5–54 months). Postoperative complications included infection (n = 4 cases), seroma (n = 2 cases), hematoma (n = 1 case), and abnormal sensation (n = 5 cases). Tumor recurrence was reported in 2 cases, and no cases developed incisional hernia during the follow-up period. Conclusion: Immediate use of omental flap with synthetic PP mesh for reconstruction of abdominal wall defects is a feasible technique and has avoided the complications associated with the use of synthetic mesh alone.

Layer-by-Layer Reconstruction of Abdominal Wall Defect Using Rectus Abdominis Muscle Flap with AlloDerm

Layer-by-Layer Reconstruction of Abdominal Wall Defect Using Rectus Abdominis Muscle Flap with AlloDerm

1024 The Use of the Pedicled Anterolateral Thigh (ALT) Flap for the Reconstruction of Abdominal Wall Defects in High-Risk Patients: A Case Series and Systematic Review

Abstract Introduction The pedicled anterolateral thigh (ALT) flap is considered as a suitable option in complex abdominal wall reconstruction. Its use as a reconstructive option is infrequent in the literature, and to date, there has been no systematic review evaluating its long-term outcomes. We report our experience with the pedicled anterolateral thigh flap for abdominal wall reconstruction in high-risk patients. Method A prospective database was created for patients with abdominal wall defects treated with pedicled ALT with extended fascia lata flaps between 2014 and 2017. Patient demographics, aetiology, size, location of defect and post-operative results were reviewed. Abdominal defects were classified into the following zones: 1A, upper midline; 1B, lower midline; 2, upper quadrant; 3, lower quadrant. A systematic review of the literature was conducted using PUBMED and EMBASE. Results 4 patients (mean age 59.5 years, range 50-65 years) underwent reconstruction with pedicled ALT flaps. 3 flaps developed partial necrosis secondary to infection; 1 flap required surgical debridement, and 2 were managed conservatively. There was one flap failure, due to avulsion of the pedicle during inset. At mean follow up of 2.75 years (range 1 to 4 years) 3 patients have clinical bulging or herniation. Conclusions Review of the literature demonstrated 52 patients from 17 case series or reports. The overall infection and partial flap loss rates were both 6%. There were no reported flap failures. Our study demonstrates that the pedicled anterolateral thigh flap is an effective flap option for the repair of large defects of the abdominal wall in high-risk patients.

Adipose-Derived Stem Cells Based on Electrospun Biomimetic Scaffold Mediated Endothelial Differentiation Facilitating Regeneration and Repair of Abdominal Wall Defects via HIF-1α/VEGF Pathway.

Application of synthetic or biological meshes is the main therapy for the repair and reconstruction of abdominal wall defects, a common disease in surgery. Currently, no ideal materials are available, and there is an urgent need to find appropriate ones to satisfy clinical needs. Electrospun scaffolds have drawn attention in soft tissue reconstruction. In this study, we developed a novel method to fabricate a composite electrospun scaffold using a thermoresponsive hydrogel, poly (N-isopropylacrylamide)-block-poly (ethylene glycol), and a biodegradable polymer, polylactic acid (PLA). This scaffold provided not only a high surface area/volume ratio and a three-dimensional fibrous matrix but also high biocompatibility and sufficient mechanical strength, and could simulate the native extracellular matrix and accelerate cell adhesion and proliferation. Furthermore, rat adipose-derived stem cells (ADSCs) were seeded in the composite electrospun scaffold to enhance the defect repair and regeneration by directionally inducing ADSCs into endothelial cells. In addition, we found early vascularization in the process was regulated by the hypoxia inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) pathway. In our study, overexpression of HIF-1α/VEGF in ADSCs using a lentivirus system promoted early vascularization in the electrospun scaffolds. Overall, we expect our composite biomimetic scaffold method will be applicable and useful in abdominal wall defect regeneration and repair in the future.

Original method of the frontal abdominal wall defect reconstruction using the principle of the reconstructive-restorative surgery

The author srepresent the original clinical data devoting to the further progress in reconstructive surgery. The methodology of the staged anterior abdominal wall defect reconstruction using the Keystone method was used firstly.The aim of the work is to demonstrate the peculiarity of preoperative preparation of patients with the anterior abdominal wall wounds complicated by small intestinal fistulas.The article uses the clinical materials of the concrete patient treatment in the Department of surgical infection of the South Region Military Medical Clinical Centre (Odessa, Ukraine) using the principle of the reconstructive-restorative surgery.The clinical case of the successful surgical treatment of anterior abdominal wall eventration, resulting from numerous laparotomies with pronounced lateralization of the wound, has shown that the solution to this problem should be based on the principles of reconstructive surgery.Preoperative modelling of full-layer flaps using a combined technique (infrared camera FLIR and portable Doppler SONO Trax) reduces the risk of necrosis of the movable flap and accelerates the process of closing of the defect of the anterior abdominal wall. Staged (“step-by-step”) surgical treatment of the postoperative wound of the anterior abdominal wall by reconstruction via to the Keystone method showed a positive and rapid result of solving such a difficult problem as eventration complicated by small intestinal fistula.Restoration of the integrity of the anterior abdominal wall should be considered from the standpoint of reconstructive-restorative features

Original method of the frontal abdominal wall defect reconstruction using the principle of the reconstructive-restorative surgery

Original method of the frontal abdominal wall defect reconstruction using the principle of the reconstructive-restorative surgery

Biologic Mesh in Surgery: A Comprehensive Review and Meta-Analysis of Selected Outcomes in 51 Studies and 6079 Patients.

In recent decades, biologic mesh (BM) has become an important adjunct to surgical practice. Recent evidence-based clinical applications of BM include but are not limited to: reconstruction of abdominal wall defects; breast reconstruction; face, head and neck surgery; periodontal surgery; other hernia repairs (diaphragmatic, hiatal/paraesophageal, inguinal and perineal); hand surgery; and shoulder arthroplasty. Prior systematic reviews of BM in complex abdominal wall hernia repair had several shortcomings that our comprehensive review seeks to address, including exclusion of laparoscopic repair, assessment of risk of bias, use of an acceptable meta-analytic method and review of risk factors identified in multivariable regression analyses. We sought articles of BM for open ventral hernia repair reporting on early complications, late complications or recurrences and included minimum of 50. We used the quality in prognostic studies risk of bias assessment tool. Random effects meta-analysis was applied. This comprehensive review selected 62 articles from 51 studies that included 6,079 patients. Meta-analytic pooling found that early complications are present in about 50%, surgical site occurrences (SSOs) in 37%, surgical site infections (SSIs) in 18%, reoperation in 7%, readmission in 20% and mortality in 3%. Meta-analytic estimates of late outcomes included overall complications (42%), SSOs (40%) and SSIs (22%). Specific SSOs included seroma (14%), hematoma (4%), abscess (10%), necrosis (5%), dehiscence (8%) and fistula formation (5%). Reoperation occurred in about 17%, mesh explantation in 9% and recurrence in 36%. Estimates of nearly all outcomes from individual studies were highly heterogeneous and sensitivity analyses and meta-regressions generally failed to explain this heterogeneity. Recurrence is the only outcome for which there are consistent findings for risk factors. Bridge placement of BM is associated with higher risk of recurrence. Prior hernia repair, history of reintervention and history of mesh removal were also risk factors for increased recurrence.

Mesenchymal stem cell tailored bioengineered scaffolds derived from bubaline diaphragm and aortic matrices for reconstruction of abdominal wall defects.

Bioengineered scaffolds derived from the decellularized extracellular matrix (ECM) obtained from discarded animal organs and tissues are attractive candidates for regenerative medicine applications. Tailoring these scaffolds with stem cells enhances their regeneration potential making them a suitable platform for regenerating damaged tissues. Thus, the study was designed to investigate the potential of mesenchymal stem cells tailored acellular bubaline diaphragm and aortic ECM for the repair of full-thickness abdominal wall defects in a rabbit model. Tissues obtained from bubaline diaphragm and aorta were decellularized and bioengineered by seeding with rabbit bone marrow derived mesenchymal stem cells (r-BMSC). Full-thickness abdominal wall defects of 3 cm × 4 cm size were created in a rabbit model and repaired using five different prostheses, namely, polypropylene sheet, nonseeded diaphragm ECM, nonseeded aorta ECM, r-BMSC bioengineered diaphragm ECM, and r-BMSC bioengineered aorta ECM. Results from the study revealed that biological scaffolds are superior in comparison to synthetic polymer mesh for regeneration in terms of collagen deposition, maturation, neovascularization, and lack of any significant (P > 0.05) adhesions with the abdominal viscera. Seeding with r-BMSC significantly increased (P < 0.05) the collagen deposition and biomechanical strength of the scaffolds. The bioengineered r-BMSC seeded acellular bubaline diaphragm showed even superior biomechanical strength as compared to synthetic polymer mesh. Tailoring of the scaffolds with the r-BMSC also resulted in significant reduction (P < 0.01) in antibody and cell mediated immune reactions to the xenogeneic scaffolds in rabbit model.

A facile strategy for fabricating composite patch scaffold by using porcine acellular dermal matrix and gelatin for the reconstruction of abdominal wall defects.

Defects of the abdominal wall continue to be a significant issue in regenerative medicine and tissue engineering. Porcine acellular dermal matrix (P-ADM) and gelatin have been widely used for fabricating engineered abdominal wall due to their good biocompatibility and integration with host tissues. In this study, we demonstrate a novel and reproducible approach of using gelatin and P-ADM powder to fabricate composite patch scaffolds by combining solvent casting and enzymatic cross-linking for the abdominal wall regeneration in rats. Different concentration ratios of gelatin and P-ADM and different shapes of engineered scaffolds are studied for various abdominal wall defects. Skeletal muscle cells and human umbilical vein endothelial cells can successfully attach to the surface of the scaffolds and maintain high viability after culturing for five days. In vivo experiments demonstrate that there are no signs of infection, intra-abdominal adhesion, and severe inflammation after two weeks, which indicate good repairability of the scaffolds. In conclusion, we propose a novel method that holds great potential for building engineered scaffolds to meet the different requirements of abdominal wall regeneration.

External oblique muscle flap for abdominal wall reconstruction: Local solution for local problem

Reconstruction of full-thickness abdominal wall defect is difficult and is usually done by regional flaps or free tissue transfers. This creates additional donor site morbidity. A 20 cm × 15 cm full-thickness defect in the right iliac fossa of a woman after tumor excision was reconstructed successfully with right-sided external oblique muscle flap and abdominoplasty in a hitherto undescribed fashion. External oblique muscle flap with abdominoplasty can be used for reconstruction of abdominal wall defects with minimum morbidity and satisfactory esthetic appearance.

Regenerated silk fibroin (RSF) electrostatic spun fibre composite with polypropylene mesh for reconstruction of abdominal wall defects in a rat model

Abdominal wall defects are associated with abdominal wall surgery, infection and tumour resection. Polypropylene (PP) mesh, which has excellent mechanical strength, is currently the primary clinical repair material. In repairing the abdominal wall, the mesh can erode the bowel and cause other problems. Constructing a barrier that induces a weak inflammatory response and promotes rapid recovery of the peritoneum is important. We used electrospinning technology to construct a silk fibroin coating on the abdominal surface of a PP patch. A rat model was used to compare the inflammatory responses, regeneration of peritoneal tissue, and antiadhesion effects of electrospun regenerated silk fibroin (RSF) coatings, polycaprolactone (PCL) coatings, and noncoated PP meshes. The inflammatory responses, antiadhesion fractions, and areas of RSF and PCL were better than those of PP at 6 weeks. RSF was associated with complete peritoneal regeneration, in contrast to PCL. At 12 weeks, the structure of the PCL peritoneum was unstable, and the adhesion fraction and area were significantly higher than those of RSF. The intact peritoneum could not be effectively regenerated. The RSF group exhibited lower IL-6 levels than the PCL and PP groups but higher VEGF, IL-10 and TGF-β levels, making RSF more conducive to the regeneration of peritoneal and abdominal wall tissues.