Peritoneal adhesions to prosthetic materials - Choice of mesh for incisional hernia repair

Background: In many cases, incisional hernia repair requires the use of pro sthetic materials. The aim of this experimental study in a rat model was to assess the role of polyglactin 910 mesh and fluoropassivated polyester mes h in preventing the formation of adhesions. Methods: In the first experiment, the formation of peritoneal adhesions was assessed after insertion of polypropylene, polypropylene combined with pol yglactin 910, or no mesh. In the second experiment, adhesion formations wer e compared after insertion of fluoropassivated polyester, polypropylene, an d no mesh. Results: The first experiment showed no significant difference in adhesion formations between the polypropylene mesh and the combined mesh; however, w hen no mesh was used, there were significantly fewer adhesions in both expe riments (p < 0.01). The second experiment showed a significantly lower degr ee of adhesions and a lower Adhesion Index after insertion of fluoropassiva ted polyester mesh than when polypropylene mesh was used (p = 0.04). Conclusions: Adding polyglactin 910 mesh to polypropylene mesh to prevent t he formation of adhesions is not an effective measure. Fluoropassivated pol yester meshes appear to provide a better alternative to the use of polyprop ylene meshes for incisional hernia repair in humans in terms of the formati on of adhesions.