Use of composite prostheses in the repair of defects in the abdominal wall: prosthetic behaviour at the peritoneum.

摘要

OBJECTIVE: To compare the behaviour of two composite biomaterials in rabbit peritoneum. DESIGN: Animal study. SETTING: Faculty of Medicine, University of Alcala, Spain. ANIMALS: 14 white New Zealand white rabbits divided into 2 groups of 7 each. INTERVENTIONS: Defects (7 x 5 cm) involving all the layers of the abdominal wall were created and repaired using Parietex Composite or Vypro prostheses. Fourteen days after implantation, prosthetic specimens were examined by microscopy, and morphometric and biomechanical analysis. MAIN OUTCOME MEASURES: Infection, healing, development of adhesions, and histological appearance of the interface. RESULTS: Firm adhesions were detected after the implant of Vypro while adhesion were loose in the Parietex group. The mean (SD) prosthetic surface area covered by adhesions was significantly greater in the Vypro group 22.3 (2.8) compared with 0.2 (0.02), p <0.01). The neoperitoneum formed after the implant of Parietex was well-organised and homogeneous and covered by a typical mesothelium, while in the Vypro it was disorganised, with a rough texture composed of prosthetic filaments and nodes. The neoperitonum was thicker in the Parietex group 154.0 (5.4) compared with 50.8 (2.3), p <0.05) while higher biomechanical resistance values were recorded in the Vypro group 30.4 (1.9) compared with 15.0 (2.73), p <0.05). CONCLUSIONS: While both biomaterials integrated well with tissue, Parietex behaved better at the peritoneal interface.