EVALUATION OF A NOVEL SYNTHETIC MATERIAL FOR CLOSURE OF LARGE ABDOMINAL-WALL DEFECTS

Background. This study was undertaken to compare the efficacy of a nov el synthetic material (TMS-1) with polytetrafluoroethylene, polypropyl ene, and primary closure of experimentally fashioned clean and contami nated abdominal wounds. Methods. One square centimeter full-thickness abdominal wall defects were created in each of the four abdominal quad rants of anesthetized rats (n = 6). Patches of polytetrafluoroethylene , polypropylene, and a polyurethane-polypropylene composite material ( TMS-1) were used to repair three of these defects; the fourth was prim arily closed. A second group of rats (n = 9) underwent the same operat ive protocol; however, peritonitis was induced at the time of operatio n by using the fecal inoculation technique. Animals were killed 2 to 3 weeks later, and surface area and severity of formed adhesions were a ssessed. Results. By all methods of assessment, primary closure proved significantly superior to all other methods of closure in clean and c ontaminated conditions. The three synthetic materials were equally mat ched for surface area involved in adhesion formation. When compared wi th the other synthetic materials, TMS-1 was associated with significan tly milder adhesions in uninfected (p < 0.002) and in infected (p < 0. 002) conditions. Conclusions. The clear superiority of TMS-1 over othe r nonabsorbable synthetic materials shown in this pilot study warrants further investigation relative to its use to close large abdominal wa ll defects.