The impact of hydrophobic hernia mesh coating by omega fatty acid on atraumatic fibrin sealant fixation.

Abstract

BACKGROUND: Fibrin sealant (FS) is a safe and efficient fixation method in open intraperitoneal hernia repair. While favourable results have been achieved with hydrophilic meshes, hydrophobic (such as Omega fatty acid coated) meshes (OFM) have not been specifically assessed so far. Atrium C-qur lite(®) mesh was tested in rats in models of open onlay and intraperitoneal hernia repair. METHODS: 44 meshes (2 × 2 cm) were implanted in 30 male Sprague-Dawley rats in open (n = 2 meshes per animal) and intraperitoneal technique (IPOM; n = 1 mesh per animal). Animals were randomised to four groups: onlay and IPOM sutured vs. sealed. Follow-up was 6 weeks, sutured groups serving as controls. Evaluation criteria were mesh dislocation, adhesions and foreign body reaction. RESULTS: FS provided a reliable fixation in onlay technique, whereas OFM meshes dislocated in the IPOM position when sealed only. CONCLUSION: FS mesh fixation was safe with OFM meshes in open onlay repair. Intraperitoneal placement of hydrophobic meshes requires additional fixation and cannot be achieved with FS alone.