Long term comparative evaluation of two types of absorbable meshes in partial abdominal wall defects: an experimental study in rabbits

摘要

Purpose Synthetic prosthetic materials that are fully absorbable seek to reduce the host foreign body reaction and promote host tissue regeneration. This preclinical trial was designed to analyse, in the long term, the behaviour of two prosthetic meshes, one synthetic and one composed of porcine collagen, in abdominal wall reconstruction. Methods Partial defects were created in the abdominal walls of New Zealand rabbits and repaired using a synthetic absorbable mesh (Phasix (TM)) or a non-crosslinked collagen bioprosthesis (Protexa (TM)). After 3, 6, 12 and 18 months, specimens were recovered for light microscopy and collagen expression analysis to examine new host tissue incorporation, macrophage response and biomechanical strength. Results Both materials showed good host tissue incorporation in line with their spatial structure. At 18 months postimplant, Protexa (TM) was highly reabsorbed while the biodegradation of Phasix (TM) was still incomplete. Collagenization of both materials was good. Macrophage counts steadily decreased over time in response to Phasix (TM), yet persisted in the collagen meshes. At 18 months, zones of loose tissue were observed at the implant site in the absence of herniation in both implant types. The stress-stretch behaviour of Phasix (TM) implants decreased over time, being more pronounced during the period of 12-18 months. Nevertheless, the abdominal wall repaired with Protexa (TM) became stiffer over time. Conclusion Eighteen months after the implant both materials showed good compatibility but the biodegradation of Phasix (TM) and Protexa (TM) was incomplete. No signs of hernia were observed at 18 months with the stress-stretch relations being similar for both implants, regardless of the more compliant abdominal wall repaired with Protexa (TM) at short term.