THE EFFICACY OF POLYPROPYLENE, POLYGLACTIN AND E-POLYTETRAFLUOROETHYLENE MESHES IN THE REPAIR OF ABDOMINAL WALL DEFECTS

Abstract

Repair of wide abdominal wall defects is an important surgical problem. This study aims to evaluate the efficacy of three different synthetic meshes (polypropylene, polyglactin and expanded-polytetraffuoroethylene) in the repair of abdominal wall defects. Four groups, each consisting of ten rats, named as control polypropylene mesh, polyglactin mesh and expanded polytefrafluoroethylene (e-PTFE) mesh respectively were formed. In the control group only laparotomy was performed. In other groups, a 3x2 cm full thickness abdominal wall defect including peritoneum was made and the abdomen was repaired by 4x3 cm meshes. Half of the rats were sacrificed in the fifth week and the rest in the tenth week. Meshes were compared using four parameters: Adhesions, tensile strength, histopathologic analysis and tissue hydroxyproline levels. On the tenth week, adhesions were most in the polypropylene group and the least in the e-PTFE group; but these results were non-significant. In the polypropylene group, tissue tensile strength was higher than the other groups both in the 5th and 10th weeks; this high value was significant in comparison to the e-PTFE group in the 5th week and to the control group in the 10th week (p<0.01). In the histopathological evaluation, inflammatory reaction was highest in the polypropylene group (p<0.05). Inflammatory cell infiltration was highest in the polypropylene group in the 5th week (p<0.01). Tissue hydroxyproline levels were significantly higher in the polypropylene mesh group than in the polyglactin group in the 10th week (p<0.01). In conclusion, when all parameters were considered, the polypropylene mesh was found to be superior in abdominal wall defect repair. According to histopathologic results, in cases with direct organ contact, where the use of polypropylene mesh is still debatable, polyglactin and e-PTFE meshes may be preferred.