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

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 (R) or Vypro (R) p rostheses. Fourteen days after implantation, prosthetic specimens were exam ined by microscopy, and morphometric and biomechanical analysis. Main outcome measures: Infection, healing, development of adhesions, and hi stological appearance of the interface. Results: Firm adhesions were detected after the implant of Vypro while adhe sion were loose in the Parietex group. The mean (SD) prosthetic surface are a 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 ty pical mesothelium, while in the Vypro it was disorganised, with a rough tex ture composed of prosthetic filaments and nodes. The neoperitonum was thick er in the Parietex group 154.0 (5.4) compared with 50.8 (2.3), p < 0.05) wh ile 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.