Evaluation of composite synthetic greft use in treatment of rat ventral hernia in which A contaminated field is created by experimental peritonitis model

ABSTRACT BACKGROUND There is still some problem in the treatment of large abdominal wall defects accompanied contamination and some emergent cases in which very large defects occurred in the abdominal wall. In literature any clinically prospective randomized controlled trial about the use of synthetic meshes in such cases did not exist. So the aim of this experimental study is to shed light to clinical studies by evaluating the safety and efficacy of Ventralight™ ST (a new composite synthetic mesh composed of lightweight polypropylene and bioresorbable antiadhesive hydrogel barrier suitable for intraperitoneal replacement) in rats peritonitis model. METHODS In the study 20 wistar albino rats were operated. The cecal ligation and puncture model was used to induce peritonitis. After 24 hours, rat were randomized into two equal groups. After excising the necrotic cecum and irrigating the abdominal cavity with warm saline first group was treated by primary closure and the second group was treated by Ventralight™ ST reinforcement. Then rats were followed 28 days. And sepsis, mortality caused by sepsis, surgical site infection and mesh infections were observed until that time. All surviving animals were sacrified on 28th day. Intraabdominal abscess formations were looked, microbiological cultures were obtained and intraabdominal adhesion tenacity and percentage of adhesions were graded. RESULTS There was no significant difference between groups in septic mortality (p=0.21). Yet %30 mortality was seen in ventralight group, there was no mortality in primary closure group. Surgical site infection rates were %20 in primary closure group and %57.1 in ventralight group. Although surgical site infections were more seen in ventralight group, there was no significant difference between these groups. No intraabdominal abscess seen in any animals. The microbiological tissue cultures were compared and significantly more bacterial colonization was found in ventralight group (P=0.003). After 28 days, significantly more adhesion coverages and tenacities to the abdominal wall surface were found in vetralight group (p=0.018).. COCLUSION It's seen that using synthetic composite meshes for ventral herania repairs in contaminated and dirty abdomens is not recommended althogh there is no istatistically significant difference between groups in mortality and surgical site infections. It is important to find out ideal mesh replacement therapy in such cases with new studies in which more subject are used. KEYWORDS Ventral hernia, contaminated field, senthetic greft, peritonitis, adhesion