Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2020 , Vol 11, Issue 1
The Effect of Chitin Material On Prophylaxis of Adhesions Due To Intraperitoneal Polypropylene Mesh
Arif Hakan Demirel1,Kazım Çağlar Özçelik1
1Ankara Eğitim ve Araştırma Hastanesi, Genel Cerrahi, Ankara, Türkiye
2Yıldırım Beyazıt Üniversitesi Yenimahalle Eğitim ve Araştırma Hastanesi, Cerrahi Onkoloji, Ankara, Türkiye
DOI : 10.31067/0.2020.248 Purpose/Aim: Polypropylene mesh is the most applied and used material in the repairing of the abdominal wall. The purpose of this study is the evaluation of the efficiency of chitin, an anti-adhesive mucopolysaccharide, coated polypropylene mesh and liquid chitin on the formation of adhesion induced by polypropylene mesh.

Materials and Methods: Thirty male Wister Albino rats were divided into 3 groups randomly. In Group A, the abdominal defect was closed only by polypropylene mesh, in Group B, polypropylene mesh with liquid chitin was used and in Group C, chitin film was applied to the inner side of the polypropylene mesh that was attached to the abdomen. Separation of polypropylene meshes from the fascia, location and shape transformation of them, existence of foreign body granuloma between the material and abdominal structures, rupture pressure of the material and the other morbidities were observed and evaluated.

Results: There was adhesion with omentum in all groups. In Group A, liver adhesion was detected in 7 cases and small intestine adhesion was detected in 3 cases. The thickness of adhesion was measured as 19.25 mm and rupture pressure was measured as 2.57 kg. In Group B, there was small intestine adhesion in all cases and bladder adhesion was detected in 2 cases. The thickness of adhesion and rupture pressure was measured on an average as 37.52 mm and 2.42 kg respectively. Similar to Group B, in Group C, there was small intestine adhesion in all cases. Moreover, there was bladder adhesion in 4 cases, pancreas adhesion in 1 case and large intestine in 1 case. The thickness of adhesion and rupture pressure was measured on average as 46,14mm and 1.97 kg respectively. The number and thickness of the adhesion were statistically much more observed in Group A according to/in comparison to Group B and C statistically (p<0.05). However, any difference in the development and the diameter of adhesion in B and C group was not detected. Mesh rupture pressure was not different statistically.

Conclusion: In our study, contrary to expectations, any positive effect of using an anti-adhesive material, chitin, with polypropylene mesh on the protection of adhesion development was not detected. Keywords : Adhesion, chitin, mesh