Efficacy of polypropylene mesh coated with bioresorbable membrane for abdominal wall defects in mice.

ABSTRACT

Incisional hernias due to trauma, infection, or tumor are a common abdominal wall defect. Repair of these defects when autogenous tissue is insufficient or inadequate often results in abdominal tissue adhesion. These adhesions often lead to complications such as intestinal obstruction and enterocutaneous fistula. Previous reports have shown that application of prosthetic materials, such as polypropylene mesh and anionic polysaccharides, has been effective in reducing the amount of tissue adhesion. However, some tissue adhesion still occurs with application of these materials when previously described methodologies are used. We evaluated the efficacy of a novel surgical approach that combines the application of Sepramesh, a coated polypropylene mesh, and Seprafilm, composed of anionic polysaccharides (both products from Genzyme, Cambridge, MA), in the repair of abdominal wall hernias. We report that combined application of these 2 materials in a "sandwich technique", by placing the peritoneum between the Seprafilm and Sepramesh, further reduces (and in some instances prevents) tissue adhesion after abdominal wall defects in mice. Moreover, our combined treatment markedly decreased tissue inflammation after hernia repair.