Use of small intestinal submucosal implants for regeneration of large fascial defects: An experimental study in dogs

A single layer of porcine small intestinal submucosa (SIS) was sutured into a 5 x 5 cm window created in the fascia lata of ten adult mongrel dogs in order to determine the efficacy of this material in promoting tissue regene ration of large fascial defects. A similar defect in the contralateral limb was left empty and served as a negative control. Tissue regeneration was e xamined grossly and histologically at 6 and 12 weeks. By 6 weeks, marked fi broplasia and angiogenesis had occurred throughout the SIS scaffold. The re generated tissue was well organized and showed good integration with the ad jacent fascia while the control specimens were filled with loose areolar co nnective tissue. At 12 weeks the experimental defects were filled with a re generated tissue that grossly and histologically resembled normal fascia. T here was no evidence of adhesions to the underlying musculature. Conversely , the tissue that filled the control defects remained disorganized and was markedly thinner than the adjacent fascia. The results of this study sugges t that SIS is capable of supporting tissue regeneration in large fascial de fects. The ability of this material to induce regeneration of a substantial area of tissue grossly and histologically similar to normal fascia and wit hout adhesions to the underlying musculature makes its application in recon structive surgery appear promising. (C) 1999 John Wiley & Sons, Inc.