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120-Day Comparative Analysis of Adhesion Grade and Quantity, Mesh Contraction, and Tissue Response to a Novel Omega-3 Fatty Acid Bioabsorbable Barrier Macroporous Mesh After Intraperitoneal Placement

Department of Surgery and Institute for Minimally Invasive Surgery, Washington University School of Medicine, Saint Louis, Missouri

Juan M. Perrone, MD

Department of Surgery and Institute for Minimally Invasive Surgery, Washington University School of Medicine, Saint Louis, Missouri

Abdelrahman Nimeri, MD

Department of Surgery and Institute for Minimally Invasive Surgery, Washington University School of Medicine, Saint Louis, Missouri

Jennifer A. Sexton, MD

Department of Surgery and Institute for Minimally Invasive Surgery, Washington University School of Medicine, Saint Louis, Missouri

Julie Walcutt, BS

Department of Surgery and Institute for Minimally Invasive Surgery, Washington University School of Medicine, Saint Louis, Missouri

Margaret M. Frisella, RN

Department of Surgery and Institute for Minimally Invasive Surgery, Washington University School of Medicine, Saint Louis, Missouri

Brent D. Matthews, MD

Department of Surgery and Institute for Minimally Invasive Surgery, Washington University School of Medicine, Saint Louis, Missouri, matthewsb{at}wudosis.wustl.edu

Purpose. This study aimed to evaluate adhesion formation, mesh contraction, and tissue response to an omega-3 fatty acid barrier—coated lightweight polypropylene mesh (C-Qur) after intra-abdominal placement, and compare these properties to those of other commercially available meshes. Materials and methods. After randomization, 3 x 3 cm pieces of Atrium C-Qur, Mesh ProLite Ultra, Composix, Parietex, Proceed, Sepramesh, and DualMesh were sewn to the intact peritoneum on either side of a midline incision in 41 New Zealand white rabbits. Necropsy was performed at 120 days, and explants were evaluated for adhesion grade, adhesion amount, and mesh contraction. Histologic evaluation included extent of capsule formation, abdominal wall tissue ingrowth, degrees of inflammation and vascularization of the surrounding tissue, and the presence of mesothelialization. Results. There were no significant differences between the C-Qur mesh and the commercially available meshes tested with regard to adhesion grade or amount, although percentage adhesion coverage for the C-Qur mesh was much less than for Composix and Proceed. The C-Qur mesh contracted less than all meshes, significantly less (P < .05) than DualMesh or Proceed. DualMesh exhibited the greatest amount of capsule formation and inflammation on its parietal side as compared with the other meshes. Conclusions. Placing lightweight polypropylene mesh with an omega-3 fatty acid barrier coating intraperitoneally results in more favorable adhesion characteristics compared with Composix and Proceed meshes at 120-day explantation after intraperitoneal placement. The minimal amount of contraction and favorable tissue response in comparison to other commercially available meshes makes C-Qur mesh a practical alternative for laparoscopic and open ventral hernia repair.

Key Words: ventral hernia • laparoscopy • surgical mesh • omega-3 fatty acids • abdominal adhesions • peritoneum

This version was published on March 1, 2009

Surgical Innovation, Vol. 16, No. 1, 46-54 (2009)
DOI: 10.1177/1553350608330479


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