Reinforcement of colon anastomoses with polyglycolic acid mesh: an experimental study.

Polyglycolic acid (PGA) meshes have successfully been used in the treatment of injured parenchymatous organs. In our study we investigated the value of PGA meshes for reinforcement of colon anastomoses in a rat model. In 75 Wistar rats the transverse colon was transected and reanastomosed in a single-layer technique. The anastomoses in half of the animals were performed with 6 stitches. In the other animals the anastomoses were performed with 4 stitches only and were therefore supposed to leak. In half of the animals of each group a PGA mesh was used to cover the anastomoses. Animals of each group were sacrificed after 2, 4, 8, 30 and 60 days. The bursting strength of the anastomoses was determined and the anastomosed region was examined histologically. The results demonstrate that regardless of how the anastomosis was applied motility disorders, delayed healing or leakage followed by peritonitis only occurred in animals in which a PGA mesh was used. The determination of the bursting strength also showed a marked decrease in all rats in which the anastomosis was reinforced with a PGA mesh. We therefore conclude that PGA mesh application in colon anastomoses results in impaired healing, which is probably due to reduced peritoneal or omental contact.