Comparative study of polypropylene mesh and oxidized regenerated cellulose polypropylene - polydioxanone composite mesh - An experimental study of ventral hernia repair in albino rats
Dr Devashish Kaushal, Dr Mandavi Agarwal
Background The overall incidence of incisional hernia after laparotomy is 9.9%. Currently polypropylene mesh is used most commonly for hernia repair, but this prosthetic mesh is commonly associated with adhesions formation between prosthetic mesh and abdominal viscera when it is applied intraperitoneally. Therefore we did an experimental study in albino rats with two different types of meshes; first most commonly used polypropylene mesh and another polypropylene–polydioxanone composite with oxidized regenerated cellulose (ORC) coating to compare the propensity of adhesion formation on visceral side of mesh. Material and Method 50 rats were divided in two groups polypropylene and ORC polypropylene–polydioxanone composite mesh group with twenty five rats in each group. In all groups ventral abdominal defect was created and mesh was applied intraperitoneally, rats were sacrifice on 7 & 30 days for examining adhesion formation. Adhesion scoring were done by adhesion area score and severity score developed by Vanderbilt University, Nashville USA along with histo-pathological examination of mesh with surrounding tissue. Result There was statistically significantly less adhesion formation in the ORC coated polypropylene-polydioxanone composite mesh group. Combine area & severity score was 2.4 and 2.1 on seven and thirty days respectively in ORC coated polypropylene-polydioxanone composite mesh group while it was 4.8 and 4.9 in polypropylene group at the same time interval (p=0.02 & p<0.01). Similarly histo-pathological grading also confirmed that more dense adhesions formed in polypropylene group that were grade III on day thirty and grade II on day seven of mesh application in polypropylene group & grade II in on day thirty and grade I on day seven of mesh application in ORC coated polypropylene - polydioxanone composite mesh group. Conclusion Oxidized regenerated cellulose coated polypropylene - polydioxanone composite mesh significantly reduced adhesion formation and prevented bowel adhesion to the mesh in the early postoperative period.
Dr Devashish Kaushal, Dr Mandavi Agarwal. Comparative study of polypropylene mesh and oxidized regenerated cellulose polypropylene - polydioxanone composite mesh - An experimental study of ventral hernia repair in albino rats. International Journal of Medical and Health Research, Volume 4, Issue 5, 2018, Pages 75-79