Free omental patch as the promising future for incisional hernia surgery: an experimental study in rat model

INTRODUCTION: Incisional hernia is the common complication of abdominal surgery with serious morbidity. The use of Composite mesh (CM) is the current gold standard, which is superior to Polypropylene mesh (PPM) for closing the defect, due to its minimal intraabdominal adhesion. In this study, we were using the novel combination of free omental patch (FOP) and PPM compared to CM for defect closure surgery in incisional hernia using rat models. We compared the gene expression of VEGF, COL3A1, COL1A1, COL1A2, and ratio of COL1A1/COL3A1 as the representative of wound healing process from all treatment options.

MATERIALS AND METHODS: Eighteen wistar rats were made into incisional hernia models and divided into three groups of FOP, FOP-PPM, and CM at the 14th day. After each group underwent hernia repair, abdominal wall samples were taken to examine the expression of qPCR VEGF, COL3A1, COL1A1, and COL1A2 at the 21st day.

RESULTS: There were no significant different in the gene expression of VEGF, COL3A1, COL1A1, COL1A2 and COL1A1/COL3A1 ratio between FOP, FOP-PPM and CM group (p-value >0.05). In addition, non-significant result also found at the comparative analysis between FOP-PPM and MC groups.

CONCLUSIONS: FOP can give the similar result as CM for defect closure surgery in incisional hernia, either when combined with PPM or as a single option. However, further clinical study is needed to support this animal study.