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
Scott Washburn, Jamie L. Jennell, and Steve J. Hodges. Halofuginone- and Chitosan-Coated Amnion Membranes Demonstrate Improved Abdominal Adhesion Prevention. TheScientificWorldJOURNAL (2010) 10, 2362–2366.
Sefa Kelekci . Dilek Uygur .Bulent Yilmaz .Necdet Sut .Narter Yesildaglar. Comparison of human amniotic membrane and hyaluronate/carboxymethylcellulose membrane for prevention of adhesion formation in rats. Arch Gynecol Obstet (2007) 276:355–359.
Szabo A, Haj M, Waxsman I, Eitan A (2000) Evaluation of sepra-film and amniotic membrane as adhesion prophylaxis in mesh repair of abdominal wall hernia in rats. Eur Surg Res, 32:125–128
M.A. Ganatra. Amniotic Membrane in Surgery. JPMA ( Journal Of Pakistan Medical Association) Vol. 53. No.1 ,Jan 2003.
Ammar SA. Management of Giant Ventral Hernia by Polypropylene Mesh and Host Tissue Barrier: Trial of Simplification. J Clin Med Res. 2009 Oct; 1(4): 226–229.
Petter-Puchner AH, Fortelny RH, Mika K, Hennerbichler S, Redl H, Gabriel C. Human vital amniotic membrane reduces adhesions in experimental intraperitoneal onlay mesh repair. Surg Endosc. 2011 Jul;25(7):2125-31.
Ray NF, Denton WG, Thamer M, Henderson SC, Perry S. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg. 1998 Jan;186(1):1-9.