Autologous skin graft, human dura mater and polypropylene mesh for the repair of ventral abdominal hernias: an experimental study.

OBJECTIVE

To compare primary repair and grafting with one of two materials (one biological human dura mater, and one synthetic polypropylene mesh) or autologous skin, with primary repair alone in abdominal wall hernias in rats.

DESIGN

Randomised experiment.

SETTING

Teaching hospital, Turkey.

ANIMALS

72 male Wistar albino rats randomised into 4 groups of 18 rats each. These were further randomly divided into subgroups of 6 each that were killed on days 15, 30,and 45 postoperatively.

INTERVENTIONS

Each test material was sutured to the abdominal wall by an onlay technique.

MAIN OUTCOME MEASURES

Macroscopic and microscopic appearance, and strength of the abdominal wall.

RESULTS

Macroscopically, dura mater grafts lost their original shape, but polypropylene and skin did not. When completely incorporated the skin grafts had developed a new fascia. Dura mater and polypropylene induced a pronounced inflammatory reaction at all three times postoperatively, and there were significantly more fibroblasts in the dura mater group on days 15 and 30, and in the skin graft group on day 45, than in the other groups (p < 0.05). Mechanical resistance and mean breaking strength were significantly greater in the skin graft group than in the other groups at all times tested (p < 0.05).

CONCLUSION

Full thickness autologous skin grafts were stronger than both human dura mater and polypropylene mesh when used to reinforce primary repairs of abdominal wall hernias in rats.