Autologous skin graft, human dura mater and polypropylene mesh for the repair of ventral abdominal hernias: An experimental study

Objective: To compare primary repair and grafting with one of two materials tone biological human dura mater, and one synthetic polypropylene mesh) or autologous skin, with primary repair alone in abdominal wall hernias in ra ts. Design: Randomised experiment. Setting: Teaching hospital, Turkey. Animals: 72 male Wistar albino rats randomised into 4 groups of 18 rats eac h. These were further randomly divided into subgroups of 6 each that were k illed on days 15, 30, and 45 postoperatively. Interventions: Each test material was sutured to the abdominal wall by an o nlay technique. Main outcome measures: Macroscopic and microscopic appearance, and strength of the abdominal wall. Results: Macroscopically, dura mater grafts lost their original shape, but polypropylene and skin did not. When completely incorporated the skin graft s had developed a new fascia. Dura mater and polypropylene induced a pronou nced inflammatory reaction at all three times postoperatively, and there we re significantly more fibroblasts in the dura mater group on days 15 and 30 , and in the skin graft group on day 45, than in the other groups (p < 0.05 ). Mechanical resistance and mean breaking strength were significantly grea ter in the skin graft soup than in the other groups at all times tested (p < 0.05). Conclusion: Full thickness autologous skin grafts were stronger than both h uman dura mater and polypropylene mesh when used to reinforce primary repai rs of abdominal wall hernias in rats.