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International Urogynecology Journal

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01.08.2014 | Original Article

Effectiveness of Hyalobarrier and Seprafilm to prevent polypropylene mesh shrinkage: a macroscopic and histological experimental study

verfasst von: Erdogan Nohuz, Maher Alaboud, Claude Darcha, Abdelkrim Alloui, Bruno Aublet-Cuvelier, Bernard Jacquetin

Erschienen in: International Urogynecology Journal | Ausgabe 8/2014

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Abstract

Introduction and hypothesis

Polypropylene (PP) mesh shrinkage represents a serious complication, as a significant cause of pain and recurrence of pelvic organ prolapse or ventral hernias, frequently requiring several surgical interventions. The retraction seems to be caused by the host, in response to the implantation, through the occurrence of periprosthetic adhesions and fibrosis. We hypothesized that avoiding the postoperative adhesions can prevent PP mesh shrinkage.

Methods

Sixty rats were randomly assigned to three groups. A standardized hernia defect was induced on the abdominal wall, which was repaired using an extraperitoneal PP mesh alone (group 1), with application of a hyaluronate carboxymethylcellulose-based bioresorbable membrane (Seprafilm®, group 2), or an auto-cross-linked polysaccharide hyaluronan-based solution (Hyalobarrier® gel, group 3). Eight weeks after the procedure, a repeat laparotomy was performed. After scoring the adhesion and measuring the mesh surface, a microscopic study of the prosthesis-host tissue interfaces was performed.

Results

Group 1 displayed a median shrinkage of 29 % of the mesh. The Seprafilm® group (p = 0.0238) and Hyalobarrier® gel group (p = 0.0072) displayed a significantly smaller reduction of 19.12 and 17 %, respectively. Control group 1 displayed a significantly greater adhesion score (30.40) than the Seprafilm® (11.67, p = 0.0028) and Hyalobarrier® gel groups (11.19, p = 0.0013). The fibrosis was reduced in the Hyalobarrier® gel group only.

Conclusion

This experimental study revealed that Hyalobarrier® gel and Seprafilm® can prevent PP mesh shrinkage and postoperative adhesions. They might be integrated in a mesh size-saving strategy, which should preserve the quality and durability of the surgical repair and limit the postoperative pain.

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Titel: Effectiveness of Hyalobarrier and Seprafilm to prevent polypropylene mesh shrinkage: a macroscopic and histological experimental study
verfasst von: Erdogan Nohuz
Maher Alaboud
Claude Darcha
Abdelkrim Alloui
Bruno Aublet-Cuvelier
Bernard Jacquetin
Publikationsdatum: 01.08.2014
Verlag: Springer London
Erschienen in: International Urogynecology Journal / Ausgabe 8/2014
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-014-2357-2

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Effectiveness of Hyalobarrier and Seprafilm to prevent polypropylene mesh shrinkage: a macroscopic and histological experimental study