Hyaluronic acid/carboxymethylcellulose membrane barrier versus taurolidine for the prevention of adhesions to polypropylene mesh

Eur Surg Res. 2006;38(4):414-7. doi: 10.1159/000094748. Epub 2006 Jul 26.

Abstract

Background: A hyaluronic acid/carboxymethylcellulose (HA/CMC) membrane is an effective measure to prevent polypropylene mesh induced adhesions. We hypothesized that taurolidine 2% solution might be a cost-effective alternative to decrease adhesion formation.

Materials and methods: Twenty-four rats were randomized into three groups: mesh alone (group 1), mesh + taurolidine 2% (group 2), and mesh + HA/CMC (group 3). Polypropylene mesh (4 cm2) was used to repair surgically induced anterior abdominal wall defects. Taurolidine 2%or a HA/CMC membrane was used as an antiadhesive measure. The animals were sacrificed 6 weeks after the operation, and adhesions to the prosthetic material were evaluated with digital image analysis.

Results: Group 1 (mesh alone) had the highest adhesion ratio (58.5 +/- 4.8%) compared with groups 2 and 3 (p < 0.05). The differences between groups 2 (mesh + taurolidine 2%; adhesion ratio 42.9 +/- 1.6%) and 3 (mesh + HA/CMC; adhesion ratio 40.3 +/- 3.0%) were not significant (p > 0.05).

Conclusions: The animals of both treatment groups (2 and 3) had lower adhesion ratios compared with the controls (group 1). In particular, the HA/CMC membrane did not present with a superior antiadhesive effect compared with taurolidine. Therefore, taurolidine is a cost-effective alternative to HA/CMC membranes when a polypropylene mesh is used in direct contact with the abdominal viscera.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Antineoplastic Agents / therapeutic use*
  • Carboxymethylcellulose Sodium / therapeutic use
  • Male
  • Membranes, Artificial
  • Polypropylenes / adverse effects
  • Postoperative Complications / prevention & control
  • Rats
  • Rats, Wistar
  • Surgical Mesh / adverse effects*
  • Taurine / analogs & derivatives*
  • Taurine / therapeutic use
  • Thiadiazines / therapeutic use*
  • Tissue Adhesions / prevention & control*

Substances

  • Antineoplastic Agents
  • Membranes, Artificial
  • Polypropylenes
  • Thiadiazines
  • Taurine
  • taurolidine
  • Carboxymethylcellulose Sodium