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A B D O M I N A L
S U R G E R Y
MIND YOUR MESH
Coatings Effective Against Adhesions
C
oated surgical meshes tend to reduce
the incidence of adhesions, regardless
of the type of coating with which
they've been fortified, say Dutch researchers in
the June 2013 issue of the journal Surgical
Endoscopy (tinyurl.com/qd3sdsp).
In an animal study conducted at
Maastricht University Medical Centre in the
Netherlands, they compared laparoscopic
incisional hernia repair outcomes after
using polypropylene meshes coated with
absorbable collagen, absorbable omega-3
fatty acids, absorbable cellulose and nonabsorbable PTFE, polyester mesh coated
with absorbable collagen, uncoated
polypropylene mesh and uncoated collagen
mesh.
While the coated meshes (and the uncoated collagen mesh) performed similarly well in
reducing incidents of adhesions, the uncoated polypropylene performed much less well.
"The physical presence of a layered coating
between the intraperitoneal content and the
abdominal wall," concluded the researchers,
"seems to be more important than the chemical properties of the coating in adhesion
formation." — David Bernard
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option in the eyes of
clinical authorities.
When I started my
residency in the
1980s, we were
encouraged not to use
mesh — in fact, it was
nearly heretical to —
and advised to sew up
defects with suture
instead.
To be fair, the conventional wisdom of
the time wasn't entirely unwarranted. As a
foreign object, mesh
has the potential to
cause damage in the
area it's intended to
treat. Even when
implanted correctly, it
can cause foreign
body reactions, pain,
infection, adhesions,
bowel ingrowth and
other complications.
With time, with
refined techniques and
with observation,
however, abdominal
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2013
