Effectiveness of Hyalobarrier and Seprafilm to prevent polypropylene mesh shrinkage: a macroscopic and histological experimental study
| Autor: | Claude Darcha, Maher Alaboud, Bernard Jacquetin, Abdelkrim Alloui, Bruno Aublet-Cuvelier, Erdogan Nohuz |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Urology Periprosthetic Biocompatible Materials Tissue Adhesions Polypropylenes Rats Sprague-Dawley Random Allocation Postoperative Complications Fibrosis Animals Medicine Hyalobarrier Hernia Prospective Studies Hyaluronic Acid Shrinkage business.industry Obstetrics and Gynecology Surgical Mesh medicine.disease Hernia Abdominal Prosthesis Failure Rats Surgery Surgical mesh Female business Complication Gels Abdominal surgery |
| Zdroj: | International Urogynecology Journal. 25:1081-1087 |
| ISSN: | 1433-3023 0937-3462 |
| DOI: | 10.1007/s00192-014-2357-2 |
| Popis: | Polypropylene (PP) mesh shrinkage represents a serious complication, as a significant cause of pain and recurrence of pelvic organ prolapse or ventral hernias, frequently requiring several surgical interventions. The retraction seems to be caused by the host, in response to the implantation, through the occurrence of periprosthetic adhesions and fibrosis. We hypothesized that avoiding the postoperative adhesions can prevent PP mesh shrinkage.Sixty rats were randomly assigned to three groups. A standardized hernia defect was induced on the abdominal wall, which was repaired using an extraperitoneal PP mesh alone (group 1), with application of a hyaluronate carboxymethylcellulose-based bioresorbable membrane (Seprafilm, group 2), or an auto-cross-linked polysaccharide hyaluronan-based solution (Hyalobarrier gel, group 3). Eight weeks after the procedure, a repeat laparotomy was performed. After scoring the adhesion and measuring the mesh surface, a microscopic study of the prosthesis-host tissue interfaces was performed.Group 1 displayed a median shrinkage of 29% of the mesh. The Seprafilm group (p = 0.0238) and Hyalobarrier gel group (p = 0.0072) displayed a significantly smaller reduction of 19.12 and 17 %, respectively. Control group 1 displayed a significantly greater adhesion score (30.40) than the Seprafilm (11.67, p = 0.0028) and Hyalobarrier gel groups (11.19, p = 0.0013). The fibrosis was reduced in the Hyalobarrier gel group only.This experimental study revealed that Hyalobarrier gel and Seprafilm can prevent PP mesh shrinkage and postoperative adhesions. They might be integrated in a mesh size-saving strategy, which should preserve the quality and durability of the surgical repair and limit the postoperative pain. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink