Investigation of effectiveness polypropylene mesh coated bovine amniotic membrane with adhesion barrier (polyethylene glycol) in repair of abdominal wall hernias in rats

The purpose of this experimental work was to investigate the effectiveness of polypropylene mesh coated bovine amniotic membrane with 5% Polyethylene glycol 4000 as adhesion barrier in the repair of experimental 2 x 2 cm of abdominal hernias in rats. Thirty-two rats were divided into four groups. A 2 cm x 2 cm defect was created in the full thickness of abdominal muscle on the anterior abdominal wall at a distance of 1 cm from the xiphoid process. Polypropylene mesh was implanted in the abdominal cavity with 0/2 vicryl as inlay simple interrupted sutures (Group I,II,III,IV). The bovine amniotic membrane was cover the abdominal face of the graft (Group III and Group IV). It was given before the abdominal closure 5 ml of 5% Polyethylene glycol 4000 (Group II and Group IV) and 5 ml of 0.9% NaCl (Group I and Group III). After 21 days following the operations, a total of 32 rats were euthanized. Macroscopic evaluation was performed according to the scoring system. Grafts were excised along with abdominal wall for histopathological evaluation and were evaluated under light microscope with respect to fibrosis and inflammation. SPPS 22 program was used for statistical analysis. The differences between the groups was evaluated by Kruskal Wallis analysis of variance and Mann-Whitney U test. Comparison of the groups in terms of macroscopic adhesion severity grade; Group IV (Polypropylene mesh, bovine amniotic membrane and 5 % Polyethylene glycol 4000 ) was significantly different from Group I (Control group) (p <0.05). Group II (Polypropylene mesh and 5 % Polyethylene glycol 4000) was not significantly different from Group III (Polypropylene mesh, bovine amniotic membrane and 0.9 % NaCl) (p >0.05). Group II and Group III were not significantly different from Group I (Control group) (p >0.05). Similar results were obtained in the comparison of groups according to fibrosis and inflammation. According to the results of this experimental study, the combined use of bovine amniotic membrane and 5% Polyethylene glycol 4000 were helpful to prevent the complications of polypropylene mesh. Key Words: Polypropylene mesh, Polyethylene glycol, amniotic membrane, hernia, adhesion.