Treatment of de-peritonealized intestine with 4DryField ® PH prevents adhesions between non-resorbable intra-peritoneal hernia mesh and bowel.
| Autor: | Winny M; Department of General, Visceral and Transplant Surgery, Hannover Medical School Germany., Maegel L; Institute for Pathology, Hannover Medical School Germany., Grethe LV; Department of General, Visceral and Transplant Surgery, Hannover Medical School Germany., Jonigk D; Institute for Pathology, Hannover Medical School Germany., Borchert P; Institute for Pathology, Hannover Medical School Germany., Kaltenborn A; Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Centre-Transplantation (IFB-Tx), Hannover Medical SchoolGermany; Department of Trauma and Orthopaedic Surgery, Federal Armed Forces Hospital WesterstedeWesterstede, Germany., Schrem H; Department of General, Visceral and Transplant Surgery, Hannover Medical SchoolGermany; Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Centre-Transplantation (IFB-Tx), Hannover Medical SchoolGermany., Klempnauer J; Department of General, Visceral and Transplant Surgery, Hannover Medical School Germany., Poehnert D; Department of General, Visceral and Transplant Surgery, Hannover Medical School Germany. |
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| Jazyk: | angličtina |
| Zdroj: | American journal of translational research [Am J Transl Res] 2016 Dec 15; Vol. 8 (12), pp. 5706-5714. Date of Electronic Publication: 2016 Dec 15 (Print Publication: 2016). |
| Abstrakt: | Background: Intraperitoneal onlay meshes (IPOM) can be associated with intestine-to-mesh adhesion formation, implementing risks like pain, enterocutaneous fistula, infection, and female infertility. This study investigates, whether a treatment of impaired intestinum with the anti-adhesive and hemostyptic agent 4DryField ® PH prevents adhesion formation. Methods: In 20 male LEWIS rats uncoated polypropylene meshes were sewn to the inner abdominal wall and the cecum of the respective animal was de-peritonealized by peritoneal abrasion by a gauze swap, and meso-sutures ensured a constant contact of injured areas. Rats were treated with 4DryField ® PH gel either premixed or applied as a powder with in-situ transformation (100 mg powder plus 0.4 ml 0.9% saline solution). One week postoperatively, the extent of intestine-to-mesh adhesions and the quality of mesh ingrowth were evaluated macroscopically by two independent investigators using two scoring systems. Furthermore, specimens were analysed microscopically. All data were compared with control animals without 4DryField ® PH treatment and analysed statistically using student's t-test. Results: Treatment of de-peritonealised cecum with 4DryField ® PH significantly reduced intestine-to-mesh adhesions in both treatment groups as compared to controls without 4DryField ® PH treatment (68% reduction with premixed gel, P<0.0001; 80% reduction with in-situ gel, P<0.0001). There was no impact on the quality of mesh ingrowth, confirmed histologically by a single-layer mesothelial coverage. Conclusion: These experiments mimick clinical IPOM implantation scenarios with adjacent bowel depleted from peritoneum. 4DryField ® PH gel treatment resulted in intestinal mesothelial surface recovering without development of bowel-to-mesh adhesions. Concurrently, integration of mesh into the abdominal wall is undisturbed by 4DryField ® PH treatment. |
| Databáze: | MEDLINE |
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