Prevention of adhesions to polypropylene mesh in a rabbit model

The purpose of this study was to develop a quantitative model for evaluatin g adhesion formation and to determine whether Seprafilm (HAL-F) bioresorbab le membrane (Genzyme Corp., Cambridge, MA) is effective in preventing adhes ions to polypropylene mesh (PPM). PPM has been shown to be an effective mat erial for the repair of abdominal wall defects. One disadvantage of PPM is its tendency to form dense adhesions when in contact with abdominal viscera . HAL-F, a sodium hyaluronate/carboxymethylcellulose absorbable membrane, h as been shown to prevent adhesion formation after midline closures. Its eff icacy in preventing adhesions to PPM has not been examined previously. A 5 x 7-cm anterior abdominal wall defect was created in 24 New Zealand White r abbits. This defect was then repaired with PPM. In the experimental group, a 5 x 7-cm piece of HAL-F was placed between the mesh and the abdominal vis cera. At 30 days, the animals were killed and adhesions were categorized an d quantified using digital image analysis of inked specimens. The strength of mesh incorporation into surrounding tissues was also examined using an I nstron tensiometer. The formation of adhesions between the viscera and mesh repair was significantly reduced by the use of HAL-F. The surface area inv olved for bowel adhesions was reduced 94 per cent (P = 0.00132). The streng th of incorporation was not adversely affected. HAL-F is highly effective i n preventing adhesions to PPM, without adversely effecting the strength of mesh incorporation.