Surgical mesh with protective barrier

Mesh Complications After Hernia Surgery? A Breakthrough in Adhesion Prevention

Reese Marlowe in Health & Wellness August 2025 • 4 min read.

"New research explores how a combination of icodextrin and dimetindene maleate can significantly reduce post-operative adhesions and improve patient outcomes."

Ventral incisional hernias are a common issue after abdominal surgery, affecting 10% to 20% of patients. While surgical meshes have greatly improved hernia repair by reducing recurrence rates, they can cause adhesions when placed inside the peritoneum. These adhesions, abnormal connections between tissues, can lead to significant complications.

Adhesions can result in bowel obstruction, mesh infections, fistulas, and difficulties in future surgeries. Dealing with these complications is a major challenge. Researchers are constantly seeking new methods to prevent or reduce adhesion formation, improving patient outcomes and reducing the need for additional interventions.

This article explores a recent study on a combined treatment using icodextrin 4% and dimetindene maleate to prevent adhesions following the implantation of polypropylene and titanium-coated polypropylene meshes. This innovative approach could minimize the risks and improve the success of hernia repair surgeries.

How Does the Icodextrin and Dimetindene Maleate Combination Prevent Adhesions?

The study, published in the Journal of Surgical Research in February 2019, investigated the effectiveness of a combined treatment using icodextrin 4% and dimetindene maleate in preventing peritoneal adhesions following mesh implantation. Researchers divided sixty female white rabbits into four groups to test the treatment.

The first two groups received a lightweight polypropylene mesh, while the latter two had a titanium-coated polypropylene mesh implanted. Groups 2 and 4 were treated with intravenous dimetindene maleate and an intraperitoneal solution of icodextrin 4% during surgery, followed by intramuscular dimetindene maleate for six days post-operation.

Group 1: Polypropylene mesh implantation.
Group 2: Polypropylene mesh + intraoperative and post-operative Icodextrin 4% and dimetindene maleate.
Group 3: Titanium-coated polypropylene mesh.
Group 4: Titanium-coated polypropylene mesh + intraoperative and post-operative Icodextrin 4% and dimetindene maleate.

After a 15-day observation period, the researchers evaluated adhesion scores, the percentage of affected mesh surface, tissue hydroxyproline levels, and tissue histopathology to determine the treatment's effectiveness. They aimed to find out if the combination of icodextrin and dimetindene maleate could prevent adhesion formation in these animal models.

What are the Implications for Future Surgical Practices?

The findings suggest that combining icodextrin 4% and dimetindene maleate effectively reduces the extent and severity of adhesions. This combination can be a successful strategy for preventing adhesion formation after mesh implantation. Further research is needed to optimize the treatment and assess its long-term benefits, this study offers a promising step toward improving surgical outcomes and patient quality of life following hernia repair.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jss.2018.10.003, Alternate LINK

Title: Adhesion Prevention To Polypropylene Meshes Using Combined Icodextrin Four Percent And Dimetindene Maleate

Subject: Surgery

Journal: Journal of Surgical Research

Publisher: Elsevier BV

Authors: Konstantinos Bouliaris, Eftihia Asprodini, Panagiotis Liakos, Alexandros Diamantis, Georgios Koukoulis, Christina Befani, Stella Tzika, Konstantinos Tepetes

Published: 2019-02-01

Everything You Need To Know

What are adhesions, and why are they a concern after hernia surgery?

Adhesions are abnormal connections that can form between tissues inside the body, especially after surgical procedures like hernia repair. These connections can lead to various complications, including bowel obstruction, mesh infections, and fistulas. The placement of surgical meshes, such as polypropylene and titanium-coated polypropylene meshes, inside the peritoneum can increase the risk of these adhesions. The primary issue with adhesions is that they can cause significant problems and require additional interventions for the patient, impacting their recovery and quality of life.

What is the combined treatment being studied to prevent adhesions?

A recent study explored the use of a combination of icodextrin 4% and dimetindene maleate to prevent the formation of adhesions. This approach was tested on female white rabbits that underwent mesh implantation. During the surgery, some rabbits received an intraperitoneal solution of icodextrin 4% and intravenous dimetindene maleate, followed by intramuscular dimetindene maleate for six days. The study aimed to determine if this combination could reduce the extent and severity of adhesions.

How was the effectiveness of the combined treatment measured?

The study investigated the impact of using icodextrin 4% and dimetindene maleate after mesh implantation by evaluating several factors after a 15-day observation period. These included adhesion scores, the percentage of the mesh surface affected by adhesions, tissue hydroxyproline levels, and tissue histopathology. By analyzing these parameters, researchers could assess how effectively the combined treatment prevented adhesion formation and its overall impact on the surgical outcomes.

What are the potential benefits of using icodextrin 4% and dimetindene maleate?

The findings suggest that the combination of icodextrin 4% and dimetindene maleate is effective in reducing the extent and severity of adhesions following mesh implantation. This is significant because it could minimize complications such as bowel obstruction, mesh infections, and fistulas. The use of this treatment offers a promising step towards improving surgical outcomes and patient quality of life following hernia repair, potentially reducing the need for additional interventions.

What are the next steps in researching this adhesion prevention approach?

While the study shows promising results, further research is necessary. Optimizing the treatment protocol and assessing its long-term benefits are essential steps. Further studies may look into the long-term effects on patients, the optimal dosages, and the efficacy across various patient populations. Such future research will enhance the current understanding of adhesion prevention strategies and refine the use of icodextrin and dimetindene maleate in clinical practice to improve patient outcomes.