Seprafilm® Reduces Adhesions to Polypropylene Mesh and Increases Peritoneal Hydroxyproline

Abstract

Polypropylene mesh is an effective and widely used material in repairing abdominal wall defects, but it causes dense adhesions when in contact with abdominal viscera directly. As a consequence of this process intestinal obstruction and enterocutaneous fistula may develop. The purpose of the present study was to determine whether Seprafilm®, a bioresorbable translucent membrane, reduces abdominal visceral adhesions to polypropylene mesh and whether Seprafilm® has any effects on peritoneal tissue hydroxyproline levels. Twenty-six adult Wistar rats were used. A full-thickness abdominal wall defect was created and cecal abrasions were created to induce adhesion formation in each animal. All of the abdominal defects were repaired with polypropylene mesh. In addition a Seprafilm® membrane was laid over the abdominal viscera in the Seprafilm® group (n = 13). The abdominal cavity was evaluated for adhesion formation, and peritoneal biopsies were taken for the measurement of tissue hydroxyproline levels at the 14th day. The use of Seprafilm® resulted in significant reduction in the adhesion formation ( P = 0.002) and a significant increase in peritoneal hydroxyproline level ( P < 0.0001). These findings demonstrate that the increase of peritoneal hydroxyproline levels caused by Seprafilm® might play a role on the antiadhesive effects of Seprafilm®.