Polyester (Polyethylene terephthalate) is hydrophilic material works with the body’s natural systems to improve tissue integration while reducing negative foreign material response. Polyester offers extremely lower pain intensity and less foreign body reaction. The purpose of designated research was to compare the efficacy of two placement techniques “Onlay” versus “Intraperitoneal Onlay” polyester meshplasty for the treatment of ventral hernia. Polyester is a non-absorbable mesh. Polyester mesh is not available in Pakistan and was acquired from a local healthcare company in Dubai, United Arab Emirates. Polyester mesh is available with brand name of (Parietex®, Covidien, France).
The experimental study was conducted on 24 (twenty four) healthy rabbits presented for massive ventral hernia repair. All rabbits were thoroughly examined to rule out any other anomaly before the study. The rabbits were allocated into two different groups, viz. group-A and group-B with 12 rabbits in each group respectively. All treatments were administered intramuscularly using 1 ml insulin syringe. The “Onlay Polyester Meshplasty” (Parietex®, Covidien) a placement technique that was used for the treatment of ventral hernia in group-A. The rabbits of group-B were treated with “Intraperitoneal Polyester Meshplasty” (Parietex®, Covidien) placement technique. Ventral herniorhaphy was performed in both groups using Polyester mesh with two different placement techniques. The surgery was performed at Surgery Section, Department of CMS, UVAS, Lahore for 3 months duration (including adaptation and postoperative period). Both techniques were compared on the basis of postoperative complications (wound healing, pain evaluation, hematoma, seroma and abscess formation), inflammatory responses and adhesion formation after application of mesh fixation.
SUMMARY
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During the experiment, it was observed that “Onlay Polyester Meshplasty” resulted in a prominent pain sensation, persistent inflammatory reaction, proliferating fibroblast, more granulating tissue, macrophages appearance, increased connective tissue thickness and proliferating collagen fiber. It was observed that “Intraperitoneal Polyester Meshplasty” resulted in less pain sensation, no foreign body reaction, no neutrophil appearance and rare granulating tissue. “Intraperitoneal Polyester Meshplasty” showed remarkable advantages over “Onlay Polyester Meshplasty” in terms lower pain level, reduced size seroma and extremely less scar tissue formation. Based upon all the findings it was concluded that “Intraperitoneal Polyester Meshplasty” placement technique is safer and more effective in terms of post-operative complications and outcomes.