Abstract
Purpose/Aim: Polypropylene mesh is the most applied and used material in the repairing of the abdominal wall. The purpose of this study is the evaluation of the efficiency of chitin, an anti-adhesive mucopolysaccharide, coated polypropylene mesh and liquid chitin on the formation of adhesion induced by polypropylene mesh.Materials and Methods: Thirty male Wister Albino rats were divided into 3 groups randomly. In Group A, the abdominal defect was closed only by polypropylene mesh, in Group B, polypropylene mesh with liquid chitin was used and in Group C, chitin film was applied to the inner side of the polypropylene mesh that was attached to the abdomen. Separation of polypropylene meshes from the fascia, location and shape transformation of them, existence of foreign body granuloma between the material and abdominal structures, rupture pressure of the material and the other morbidities were observed and evaluated.Results: There was adhesion with omentum in all groups. In Group A, liver adhesion was detected in 7 cases and small intestine adhesion was detected in 3 cases. The thickness of adhesion was measured as 19.25 mm and rupture pressure was measured as 2.57 kg. In Group B, there was small intestine adhesion in all cases and bladder adhesion was detected in 2 cases. The thickness of adhesion and rupture pressure was measured on an average as 37.52 mm and 2.42 kg respectively. Similar to Group B, in Group C, there was small intestine adhesion in all cases. Moreover, there was bladder adhesion in 4 cases, pancreas adhesion in 1 case and large intestine in 1 case. The thickness of adhesion and rupture pressure was measured on average as 46,14mm and 1.97 kg respectively. The number and thickness of the adhesion were statistically much more observed in Group A according to/in comparison to Group B and C statistically p
References
- Malangoni MARM. Hernias. In: Townsend Jr CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. Philadelphia, Saunders Elsevier; 2012;1114-38.
- Diener MK, Voss S, Jensen K, Buchler MW, Seiler CM. Elective midline laparotomy closure. The INLINE systematic review and meta-analysis. Ann Surg. 2010;251:843–56. [CrossRef]
- Muysoms FE, Jairam A, López-Cano M, Śmietański M, Woeste G, Kyle-Leinhase I, et al. Prevention of Incisional Hernias with Biological Mesh: A Systematic Review of the Literature. Front Surg. 2016;3:53. [CrossRef]
- Sİrensen LT. Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch Surg. 2012;147:373–83. [CrossRef]
- Ismael H, Horst M, Farooq M, Jordon J, Patton JH, Rubinfeld IS.. Adverse effects of preoperative steroid use on surgical outcomes. Am J Surg. 2011;201:305–8. [CrossRef]
- Chow WB, Merkow RP, Cohen ME, Bilimoria KY, Ko CY. Association between postoperative complications and reoperation for patients undergoing geriatric surgery and the effect of reoperation on mortality. Am Surg. 2012;78:1137–42.
- van Ramshorst GH, Nieuwenhuizen J, Hop WC, Arends P, Boom J, Jeekel J, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg. 2010;34:20–7. [CrossRef]
- Mazuji MK, Kalambahati K, Powar B. Prevention of adhesions whith polivinilpyrolidone. Arch Surg. 1964;89:1011-5. [CrossRef]
- Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004;240:578–83. [CrossRef]
- Jayanth ST, Pulimood A, Abraham D, Rajaram A, Paul MJ, Nair A. A randomized controlled experimental study comparing chitosan coated polypropylene mesh and Proceed™ mesh for abdominal wall defect closure. Annals of Medicine and Surgery. 2015;4:388-94. [CrossRef]
- Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, Rakic S. Recurrences after laparoscopic repair of ventral and incisional hernia: lessons learned from 505 repairs. Surg Endosc 2009;23:825- 32. [CrossRef]
- Cassar K, Munro A. Surgical treatment of incisional hernia. British journal of surgery 2002;89:534-45. [CrossRef]
- Sauerland S, Walgenbach M, habermalz B, Seiler CM, Miserez M. Laparoscopic versus open hernia repair. The Cochrane Libraty 2011. [CrossRef]
- Béllon JM, Rodríguez M, Grarcía-Honduvilla N, Pascula G, Gómez V, Buján J. Peritoneal Effects of Prosthetic Meshes Used to Repair Abdominal Wall Defects. Journal of Laparoscopic & Advanced Surgical Techniques 2007;17:160-6. [CrossRef]
- Halm JA, de Wall LL, Steyerberg EW, Jeekel J, Lange JF. Intraperitoneal polypropylene mesh hernia repair complicates subsequent abdominal surgery. World J Surg 2007; 31:423-9. [CrossRef]
- DeCherney AH, diZerega GS. Clinical problem of intraperitoneal postsurgical adhesion formation following general surgery and the use of adhesion prevention barriers. Surg Clin North Am 1997;77:671-88. [CrossRef]
- Mehmet Yaşar, Zekeriya İlçe, İsmet Özaydın. The Effect Of Strech Film And Prolen Mesh Usage On Adhesion For Closure Of Abdominal Wall Defects: Experimental Study. Medical Journal of Kocaeli 2012;1:12-6.
- Natasha Udpa, Shama R. Iyer, Rohit Rajoria, Kate E. Breyer, Helen Valentine, Bhupinder Singh, et al. Effects of Chitosan Coatings on Polypropylene Mesh for Implantation in a Rat Abdominal Wall Model. Tissue Engineering. 2013; 19:23-4. [CrossRef]
- Burns JW, Skinner K, Colt S, et al. Prevention of tissue injury and postsurgical adhesions by precoating tissues with hyaluronic acid solutions. J Surg 1995;59:644-52. [CrossRef]
- Becker JM, Dayton MT, Fazio VW, Beck DE, Stryker SJ, Wexner SD, et al. Prevention of postoperative abdominal adhesions by a sodium hyaluronate based bioresorbable membrane: a prospective randomized, double-blinded, multicenter study. J Am Coll Surg 1996;183:297-306.
- Seda Bozkurt, Sezai Leventoğlu, B. Bülent Menteş, Nüket Üzüm, Ayşe Dursun. Comparison of Adhesive Properties of Different Prostetic Materials Used in Incisional Hernia Repai. Kolon Rektum Hast Derg 2007;17:203-10.
- Andrea S. Gobin, Charles E. Butler, Anshu B. Mathur. Repair and Regeneration of the Abdominal Wall Musculofascial Defect Using Silk Fibroin-Chitosan Blend. Tissue Engineering 12, 2006; 12:3384-4. [CrossRef]
İntraperitoneal Polipropilen Mesh Kullanımına Bağlı Adezyonların Proflaksisinde Chitin Materyalinin Etkisi
Abstract
Amaç: Abdominal duvar defektlerinin onarımında en sık uygulanan materyal polipropilen meshdir. Anti-adeziv bir mukopolisakkarid olan chitin maddesi ile kaplanmış polipropilen mesh ve sıvı chitinin polipropilen mesh ile indüklenen adezyon oluşumu üzerinde etkinliğinin değerlendirilmesi amaçlandı. Gereç ve yöntem: Otuz erkek Wistar Albino rat randomize 3 gruba ayrıldı. Abdominal defekt sadece polipropilen mesh ile kapatılanlar A grubunu, polipropilen mesh ile birlikte sıvı chitin uygulananlar B grubunu ve polipropilen meshin batın ile temas eden iç yüzeyine bariyer şekilde film chintin uygulananlar C grubunu oluşturdu. Gruplar arasında polipropilen meshin fasyadan ayrılıp, yer ve şekil değiştirmesi ve materyal ile abdominal yapılar arasında yabancı cisim granülomları, materyalin kopma basınçları ve diğer morbiditeler gözlendi ve değerlendirildi. Bulgular: Tüm gruplarda omentum ile adezyon mevcuttu. A grubunda 7 olguda karaciğer ve 3 olguda ince bağırsak adezyonu saptandı. Adezyonların kalınlığı ortalama 19.25 mm, kopma basıncı 2.57 kg olarak ölçüldü. B grubunda tüm olgularda ince bağırsak ve karaciğer adezyonu ayrıca 2 olguda mesane ile adezyon saptandı. Adezyonların kalınlığı ortalama 37,52 mm, kopma basıncı 2.42 kg olarak ölçüldü. C grubu, B grubuna benzer şekilde tüm olgularda ince bağırsak ve karaciğer adezyonu vardır. Ayrıca 4 olguda mesane, bir olguda pankreas diğer bir olguda ise kalın bağırsakta adezyon mevcuttu. Adezyonların kalınlığı ortalama 46,14 mm, kopma basıncı 1.97 kg olarak ölçüldü. Gruplar arasında adezyon sayısı ve adezyon kalınlığı A grubuna göre B ve C gruplarında istatiksel olarak anlamlı şekilde daha fazla izlendi p
References
- Malangoni MARM. Hernias. In: Townsend Jr CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. Philadelphia, Saunders Elsevier; 2012;1114-38.
- Diener MK, Voss S, Jensen K, Buchler MW, Seiler CM. Elective midline laparotomy closure. The INLINE systematic review and meta-analysis. Ann Surg. 2010;251:843–56. [CrossRef]
- Muysoms FE, Jairam A, López-Cano M, Śmietański M, Woeste G, Kyle-Leinhase I, et al. Prevention of Incisional Hernias with Biological Mesh: A Systematic Review of the Literature. Front Surg. 2016;3:53. [CrossRef]
- Sİrensen LT. Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch Surg. 2012;147:373–83. [CrossRef]
- Ismael H, Horst M, Farooq M, Jordon J, Patton JH, Rubinfeld IS.. Adverse effects of preoperative steroid use on surgical outcomes. Am J Surg. 2011;201:305–8. [CrossRef]
- Chow WB, Merkow RP, Cohen ME, Bilimoria KY, Ko CY. Association between postoperative complications and reoperation for patients undergoing geriatric surgery and the effect of reoperation on mortality. Am Surg. 2012;78:1137–42.
- van Ramshorst GH, Nieuwenhuizen J, Hop WC, Arends P, Boom J, Jeekel J, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg. 2010;34:20–7. [CrossRef]
- Mazuji MK, Kalambahati K, Powar B. Prevention of adhesions whith polivinilpyrolidone. Arch Surg. 1964;89:1011-5. [CrossRef]
- Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004;240:578–83. [CrossRef]
- Jayanth ST, Pulimood A, Abraham D, Rajaram A, Paul MJ, Nair A. A randomized controlled experimental study comparing chitosan coated polypropylene mesh and Proceed™ mesh for abdominal wall defect closure. Annals of Medicine and Surgery. 2015;4:388-94. [CrossRef]
- Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, Rakic S. Recurrences after laparoscopic repair of ventral and incisional hernia: lessons learned from 505 repairs. Surg Endosc 2009;23:825- 32. [CrossRef]
- Cassar K, Munro A. Surgical treatment of incisional hernia. British journal of surgery 2002;89:534-45. [CrossRef]
- Sauerland S, Walgenbach M, habermalz B, Seiler CM, Miserez M. Laparoscopic versus open hernia repair. The Cochrane Libraty 2011. [CrossRef]
- Béllon JM, Rodríguez M, Grarcía-Honduvilla N, Pascula G, Gómez V, Buján J. Peritoneal Effects of Prosthetic Meshes Used to Repair Abdominal Wall Defects. Journal of Laparoscopic & Advanced Surgical Techniques 2007;17:160-6. [CrossRef]
- Halm JA, de Wall LL, Steyerberg EW, Jeekel J, Lange JF. Intraperitoneal polypropylene mesh hernia repair complicates subsequent abdominal surgery. World J Surg 2007; 31:423-9. [CrossRef]
- DeCherney AH, diZerega GS. Clinical problem of intraperitoneal postsurgical adhesion formation following general surgery and the use of adhesion prevention barriers. Surg Clin North Am 1997;77:671-88. [CrossRef]
- Mehmet Yaşar, Zekeriya İlçe, İsmet Özaydın. The Effect Of Strech Film And Prolen Mesh Usage On Adhesion For Closure Of Abdominal Wall Defects: Experimental Study. Medical Journal of Kocaeli 2012;1:12-6.
- Natasha Udpa, Shama R. Iyer, Rohit Rajoria, Kate E. Breyer, Helen Valentine, Bhupinder Singh, et al. Effects of Chitosan Coatings on Polypropylene Mesh for Implantation in a Rat Abdominal Wall Model. Tissue Engineering. 2013; 19:23-4. [CrossRef]
- Burns JW, Skinner K, Colt S, et al. Prevention of tissue injury and postsurgical adhesions by precoating tissues with hyaluronic acid solutions. J Surg 1995;59:644-52. [CrossRef]
- Becker JM, Dayton MT, Fazio VW, Beck DE, Stryker SJ, Wexner SD, et al. Prevention of postoperative abdominal adhesions by a sodium hyaluronate based bioresorbable membrane: a prospective randomized, double-blinded, multicenter study. J Am Coll Surg 1996;183:297-306.
- Seda Bozkurt, Sezai Leventoğlu, B. Bülent Menteş, Nüket Üzüm, Ayşe Dursun. Comparison of Adhesive Properties of Different Prostetic Materials Used in Incisional Hernia Repai. Kolon Rektum Hast Derg 2007;17:203-10.
- Andrea S. Gobin, Charles E. Butler, Anshu B. Mathur. Repair and Regeneration of the Abdominal Wall Musculofascial Defect Using Silk Fibroin-Chitosan Blend. Tissue Engineering 12, 2006; 12:3384-4. [CrossRef]
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 1, 2020 |
| Published in Issue | Year 2020Issue: 1 |