Analysis of tissue inflammatory response, fibroplasia, and foreign body reaction between the polyglactin suture of abdominal aponeurosis in rats and the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone and polyester/porcine collagen meshes

ABSTRACT Purpose To compare tissue inflammatory response, foreign body reaction, fibroplasia, and proportion of type I/III collagen between closure of abdominal wall aponeurosis using polyglactin suture and intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes to repair defects in the abdominal wall of rats. Methods Forty Wistar rats were placed in four groups, ten animals each, for the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes or suture with polyglactin (sham) after creation of defect in the abdominal wall. Twenty-one days later, histological analysis was performed after staining with hematoxylin-eosin and picrosirius red. Results The groups with meshes had a higher inflammation score (p < 0.05) and higher number of gigantocytes (p < 0.05) than the sham group, which had a better fibroplasia with a higher proportion of type I/III collagen than the tissue separating meshes (p < 0.05). There were no statistically significant differences between the three groups with meshes. Conclusions The intraperitoneal implant of polypropylene/polyglecaprone and polyester/porcine collagen meshes determined a more intense tissue inflammatory response with exuberant foreign body reaction, immature fibroplasia and low tissue proportion of type I/III collagen compared to suture with polyglactin of abdominal aponeurosis. However, there were no significant differences in relation to the polypropylene mesh group.

Comparative study of fibrosis induced by Marlex®, Parietex Composite®, Vicryl® and Ultrapro® meshes1

Abstract Purpose: To evaluate the fibrosis induced by four different meshes: Marlex®, Parietex Composite®, Vicryl® and Ultrapro®. Methods: Histological cutouts of abdominal wall were analyzed with polarized light 28 days after the meshes implants and colorized by picrosirius to identify the intensity of collagen types I and III, and their maturation index. Results: When the four groups were compared, the total collagen area analyzed was bigger in groups A and D, with no difference between them. The collagen type I density was bigger in group A, with an average of 9.62 ± 1.0, and smaller in group C, with an average of 3.86 ± 0.59. The collagen type III density was similar in groups A, B and C, and bigger in group D. The collagen maturation index was different in each of the four groups, bigger in group A with 0.87, group B with 0.66, group D with 0.57 and group C with 0.33 (p = 0.0000). Conclusion: The most prominent fibrosis promotion in the given meshes was found on Marlex® (polypropylene mesh) and the Parietex Composite® (non-biodegradable polyester); the collagen maturation index was higher in the Marlex® mesh, followed by Ultrapro®, Parietex Composite® and Vicryl® meshes.

Comparative study of polyglactin 910 and simple catgut in the formation of intraperitoneal adhesions

Abstract Purpose: To compare polyglactin 910 and simple catgut sutures for the incidence of intraperitoneal adhesions. Methods: Twenty female Wistar rats were placed into two groups. Group 1 received ischemic sutures and Group 2 received polyglactin 910. Five sutures inductive of adhesions in each rat were made. After 14 days, the rats were euthanized with an assessment of the presence of adhesions, the number of sutures involved and classification according to the Granat et al. scale described by Ozel et al17. Results: In total, 19 of the 20 rats presented adhesions, with nine from Group 1 and ten from Group 2. There was a smaller number of affected sutures in Group 1, while in Group 2 the majority of the sutures formed adhesions (p=0.0197). According to the Granat et al. scale, Group 1 predominately developed fine, filamentous adhesions or thickening in a restricted area. Group 2 mainly presented extensive, thick adhesions with the involvement of the viscera (p=0.0055). Conclusion: Polyglactin 910 sutures formed more adhesions that were more extensive and thicker than the simple catgut sutures.

Vaginal vault granulations after total abdominal hysterectomy using polyglactin for vault closure.

The purpose of this study was to determine the incidence of vaginal vault granulation after total abdominal hysterectomy using polyglactin (Vicryl) for vault closure. Fifty women who underwent total abdominal hysterectomy for benign and elective conditions were included into the study. Standard surgical technique of total abdominal hysterectomy was employed except for closure of the vaginal vault performed by interrupted figure-of-eight sutures using No. 1 polyglactin. All patients were prospectively followed-up at approximately 6 weeks postoperatively and vaginal vault granulation was diagnosed as present or absent. It was found that 5 patients had vaginal vault granulation without any symptoms, giving the incidence of 10 per cent. One patient who developed vault granulation had postoperative morbidity from cuff cellulitis. The remaining 49 patients had no immediate postoperative complications.

Hemostasia e infecçäo / Haemostasis and infection

O presente estudo tem por objetivo relacionar o fio cirúrgico e sua natureza, na gênese das infecções da ferida operatória, bem como verificar se o uso do cautério propicia maiores índices de infecção. Foram utilizados 78 ratos Wistar, com peso corporal entre 180 e 250 gramas. Após anestesia geral, quatro incisões foram realizadas no dorso do animal. Para a realização da hemostasia e ao mesmo tempo síntese do plano músculo-aponeeurótico, foram utilizados três tipos de fio: Poligglactina, Algodão, Categute simples. Na Quarta incisão foi utilizado cautério. Os animais foram divididos em grupos de acordo com os procedimentos no plano músculo-aponeurótico: GI - utilizou-se fios e cautério GII - inoculou-se bactérias. GIII - utilizou-se fio, cautério e inoculou-se bactérias. Uma semana após, material foi colhido das feridas cirúrgicas para realização de culturas. O grupo GI (n=10), nenhuma das culturas destas feridas desenvolveu crescimento de microorganismos. O grupo II (n=20), 35 por cento infectaram. No grupo III (n=48), verificou-se a presença de 69,8 por cento feridas infectadas. Concluimos que o fio é importante fator na gênese de infecção de feridas independente de suas características e que o uso abusivo do cautério propiciou os maiores índices de infecção.

Estudo comparativo da resposta tecidual frente a fios de sutura de catgut, poliglactina 910 e poliglecaprone 25 em tecido subcutâneo de ratos / Comparative study of tissue ensver front of sutura of catgut, poliglactina 910 and poliglecaprone 25 in subcutaneous tissues in rats

Avaliou-se a resposta tecidual na regiäo subcutânea de ratos frente aos fios de sutura: catgut, poliglactina 910 e poliglecaprone 25. Para tanto foram utilizados 20 ratos albinos, nos quais praticaram-se três pontos de sutura em planos profundos na regiäo dorsal com os três diferentes materiais. Após períodos de 1, 2, 7 e 10 dias, grupos de cinco animais foram sacrificados para obtençäo de espécimes que foram processados e corados pela hematoxilina e eosina. Após a análise dos resultados histológicos pode-se verificar uma resposta tecidual mais favorável aos fios sintéticos que ao catgut, com menor fase exsudativa e mais precoce proliferaçäo celular. Entre estes, o fio de poliglecaprone permitiu uma melhor organizaçäo do tecido conjuntivo circunvizinho, com menor infiltrado inflamatório

Tissue reaction to different types of suture materials and techniques used for wounds closure in pregnant rabbit uterus

Cesarean section was performed on ten at term pregnant New Zealand white rabbits to compare the macroscopic and microscopic reaction to two types of suture material; polyglactine [Vicryle] and chromic catgut and two types of closure techniques; continuous and locked. In each uterine horn two incisions were made. Each incision was closed according to predetermined method by chromic catgut or Vicryle suture using either continuous or locked technique. After 40 days the animal was sacrificed. Adhesion score was given for each uterine horn. Representative sections from suture site were obtained for histologic evaluation. Microscopically chromic catgut elicited a greater degree of adhesions than Vicryle. Microscopically Vicryle, elicited a lower degree of chronic inflammatory reaction. There was no difference in tissue response betweeen continuous and locked technique. The new synthetic absorbable suture [Vicryle] is an excellent potential alternative to reduce the incidence of post-operative morbidity

Estudio comparativo con dos tipos de mallas sintéticas en plásticas intraabdominales en la rata / Comparative study with 2 synthetic mesh types in intraabdominal surgery on the rat

A 20 ratas se les realizó una plástica de la pared abdominal mediante prótesis colocadas intraperitonealmente. En 10 se empleó una malla de polipropileno y en las restantes prótesis de poliglactina 370. Luego de 45 días todos los animales habían sido sacrificados. El examen histológico demostró escasa reacción inflamatoria en los preparados con mallas absorbibles, mientras que aquellos con materiales no absorbibles desarrollaron una gran respuesta inflamatoria con la formación de bridas y granulomas. Estos hallazgos inducen, a través de un modelo experimental, a continuar evaluando y preferir en la práctica, la utilización de mallas sintéticas absorbibles, en aquellos procedimientos de reemplazo de la pared abdominal, que necesitan una prótesis en posición intraperitoneal.