Comparative evaluation of the angiogenesis factors VEGF and CD 34 on the course of the combined use of omental flap and mesh in an experimental model

Techniques such as using a mesh for abdominal hernia repair have long been essential for maintaining the abdominal wall’s integrity. Muscle, cutaneous, and omental flaps are used in hernia repairs to prevent mesh rejection or as an alternative approach. We aimed to appraise the effect of using an omental flap in complicated wounds, solely or in tandem with a mesh, and additionally to evaluate and compare the impact of VEGF and CD 34 as dominant factors in the angiogenetic process.

Twenty-eight out of initially thirty-two rats were incorporated into the study and divided into four groups, based on the meshes-consistency difference as well as the implementation or not of silicon sheet as a barrier between mesh and flap, as follows: Group A (flap + mesh 1), group B (flap + mesh 1 + silicone), group C (flap + mesh 2) and group D (flap + mesh 2 + silicone) to evaluate the impact of the silicon barrier in the combined use of omental flap and mesh. The angiogenic response was estimated based on the VEGF and CD 34 staining of hematoxylin/ eosin.

VEGF elicits more significant angiogenesis in the presence of a siloxane sheet than CD 34 (group B + D, p = 0.0034). Although not reaching statistically significant level values, there is clear evidence that in each sub-group B and D, there is more significant angiogenesis with VEGF compared to CD 34 (p = 0.076).

The combined use of an omental flap and mesh plays a crucial role in reconstructing an abdominal wall defect on a large or contaminated wound. Using a mesh and an omental flap simultaneously has proven to facilitate the healing process by increasing angiogenesis, as approved by the two factors of angiogenesis, CD 34 and VEGF, the latter showing higher specificity.

Not ratable