Study of Intra-Abdominal Adhesion After Hernia Repair with Propylene Mesh in Comparison with Amniotic Membrane Attached with Propylene Mesh in an Animal Model

Adhesions after surgery are a common cause of surgical morbidity and can lead to mechanical small bowel obstruction, female infertility and chronic pelvic pain. The aim of this study is to compare the adhesion formation after repair of hernia with propylene mesh alone and propylene mesh attached to human amniotic membrane in rats to evaluate the effect of human amniotic membrane in reducing postoperative intra-abdominal adhesion. Twenty female non-pregnant healthy rats were randomized in the case (10) and control (10) groups, and full-thickness abdominal wall defect was created in each animal. In the case group, the defect was repaired with human amniotic membrane attached to propylene mesh, and in the control group with propylene mesh alone. The rats were re-operated one month later for investigation and measurement of the intra-abdominal adhesion band formation. Adhesion development was quantitated according to Nair's classification system (NCS). The data were also analyzed with Mann-Whitney U test. In the case group, 2 rats had grade 2 adhesions, and 8 had grade 3. In the control group, 3 had grade 2 adhesions and 7 had grade 3 adhesion bands. Besides, we had 3 infected wounds in the amniotic membrane group. Although amniotic membrane has shown good effect in some previous studies, in our investigation it was not effective. In addition, it increased the rate of infection in the case group, so more studies are recommended to have exact knowledge about effectiveness of amniotic membrane in reducing postoperative intra-abdominal adhesion

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