Evaluation of seprafilm and amniotic membrane as adhesion prophylaxis in mesh repair of abdominal wall hernia in rats

Introduction: Adhesion formation following abdominal wall hernia repair wit h prosthetic mesh may lead to intestinal obstruction and enterocutaneous fi stula. Physical barriers, namely, human amniotic membrane (HAM) or Seprafil m (Genzyme, Cambridge, Mass., USA), a bioabsorbable, translucent membrane c omposed of carboxymethylcellulose and hyaluronic acid, have been reported t o prevent postsurgical intra-abdominal adhesions. Objective: Evaluating the effect of HAM and Seprafilm in preventing adhesion formation in the rat mo del of ventral hernia repair with polypropylene mesh (PPM). Material and Me thods: Sixty female Sprague-Dawley rats were divided into three groups. A f ull-thickness abdominal wall defect was created in each animal. Control ani mals had the PPM sutured into the defect, whereas in the other two groups, either HAM or Seprafilm were laid over the abdominal viscera before the rep air with PPM. Half of the animals in each group were sacrificed on the 21st postoperative day. The remaining rats of the same group were re-operated o n the 42nd day for investigation and measurement of the adhesion area in re lation to the graft area. Results: Direct mesh repair showed 52.8 and 56% a rea adhesion formation 3 and 6 weeks postoperatively, respectively. The HAM barrier covered with mesh repair demonstrated 0 and 0.96% area adhesion fo rmation, and the Seprafilm-covered mesh repair showed 0 and 0% area adhesio n formation 3 and 6 weeks postoperatively, respectively. Uncovered mesh sho wed a significantly larger adhesion area than both covered mesh (p = 0.001 and 0.001). Both HAM and Seprafilm were equally effective in preventing pos toperative adhesions. Conclusions: HAM and Seprafilm proved to be an effect ive antiadhesive barrier in PPM repair of abdominal wall hernia. Copyright (C) 2000 S. Karger AG, Basel.