Comparison of the durability of cadaveric and autologous fascia using an in vivo model

Objectives. To assess the durability of both autologous and cadaveric fasci a using an animal model. The pubovaginal sling procedure can be performed u sing autologous, cadaveric, or synthetic materials. Few data are available about the strength and durability of these materials. Methods. Rectus abdominus fascia harvested from 6 female Sprague-Dawley rat s was processed by Tutogen Medical. In 20 female Sprague-Dawley rats, three different types of fascia were implanted subcutaneously into each animal: autologous rectus abdominus fascia harvested at the time of surgery; rat ca daveric fascia processed by Tutogen; and human cadaveric fascia (Tutogen). The rats were killed at 2 months (10 rats) and 4 months (10 rats) after imp lantation. The mechanical properties of the tissue were assessed using the trouser tear test, and the fracture toughness was calculated. Results. Compared with the fracture toughness before implantation, the impl anted rat autologous fascia decreased in toughness from 1763 to 1243 J/m(2) (p = 0.12), the implanted rat cadaveric fascia decreased in toughness from 1539 to 1022 J/m(2) (p = 0.02), and the implanted human cadaveric fascia d ecreased in toughness from 2120 to 1145 J/m(2) (p = 0.09). The fracture tou ghness of the implanted rat cadaveric fascia and rat autologous fascia did not differ significantly (P = 0.29). Conclusions. The changes in strength or elasticity can be detected using th e trouser tear test to calculate the fracture toughness. Both cadaveric and autologous fascial grafts may decrease in toughness with time. The long-te rm durability of the graft may only be a minor factor in determining the su ccess of the pubovaginal sling procedure. (C) 2001, Elsevier Science Inc.