International Surgery Journal | September 2018 | Vol 5 | Issue 9 Page 2942 International Surgery Journal Yur M et al. Int Surg J. 2018Sep;5(9):2942-2947 http://www.ijsurgery.com pISSN2349-3305 | eISSN2349-2902 Original Research Article The effect of polypropylene mesh on different layers to the formation of collagen type I/ III ratio and total collagen density in incisional hernia repair Mesut Yur 1 *, Ziya Çetinkaya 2 , Tuncay Kuloğlu 3 , Dürrin Özlem Dabak 3 , Erhan Aygen 2 , Osman Doğru 4 INTRODUCTION A hernia that occurs in the anterior abdominal wall after incision is called incisional hernia. Incisional hernia is one of the common problems that occurs after surgical initiatives of the abdomen. Because of their morbidity in daily life; they cause economic burden, important labor loss and decrease life quality. 1,2 The rate of development of incisional hernia after laparotomy vary between range of 2-20% and 2-30% in America. 3,4 The treatment of incisional hernia is surgery. Nowadays, many surgical techniques are used in order to eliminate this problem. These are; repairing with suture, prosthetic mesh, biological mesh and anatomical reconstruction. Repairing with suture is not preferred because of the high recurrence rates. Especially, repairing with prosthetic mesh is a preferred technique because of lower recurrence rate. 5 Recently, mesh is used by placing it on the fascia of anterior abdominal wall (onlay), on the peritoneum under the fascia (preperitoneal), under the ABSTRACT Background: In incisional hernia patients, collagen type I/III ratio and total collagen density (TCD) emerges a main etiological factor. If they are low, recurrence risk can be high. The aim of this study was to determine the ratio of collagen type I/III and TCD after incisional hernia repair in different layers with polypropylene mesh. Methods: In the study, 40 Wistar Albino rats were used. They were divided into four equal groups: control, preperitoneal, intraperitoneal and onlay. In control group, defect was repaired with prolene suture. In other groups, prolene mesh was placed to the different layers. Incisions were reopened 30 days later, and tissue samples were taken. Samples were stained by double-immunohistochemical methods and examined under light microscope. Results: Collagen type I/III ratio and TCD was highest in preperitoneal group. Intraperitoneal group was the second highest group. There was no difference between onlay and control group for collagen type I/III ratio except TCD. There was a significant correlation between TCD and collagen type I/III ratio in all samples. Conclusions: Mesh repair in different layers has an effect on TCD and collagen type I/III ratio in incisional hernia repair. Preperitoneal layer is better than other layers. Keywords: Collagen, Incisional hernia, Polypropylene, Wound healing 1 Department of Surgical Oncology, Kanuni Training and Research Hospital, Trabzon, Turkey 2 Department of General Surgery, 3 Department of Histology and Embryology, Fırat University, Elazığ, Turkey 4 Department of General Surgery, Konya Training and Research Hospital, Konya, Turkey Received:18 May 2018 Accepted: 27 June 2018 *Correspondence: Dr. Mesut Yur, E-mail: mesutyur@hotmail.com Copyright:© the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20183711