The peritoneal response to expanded polytetrafluoroethylene and oxidized regenerated cellulose surgical adhesion barriers.
OBJECTIVE
To determine the peritoneal response to the surgical adhesion barriers expanded-polytetrafluoroethylene (ePTFE) and oxidized regenerated cellulose (ORC).


METHODS
The barriers were retrieved from the peritoneal cavities of women and mice 2 hours to 14 days after insertion and subjected to histology and electronmicroscopy.


RESULTS
Macrophages and mesothelial cells rapidly appeared on the surface of both materials. ePTFE was covered by 3 days, with the macrophages gradually being replaced by mesothelium and disappearing thereafter. By 7 days, a delicate membrane with surface mesothelial cells completely enveloped the ePTFE, creating a "pseudoperitoneum". The membrane was difficult to recover as it was fragile and not adherent to the ePTFE. ORC was rapidly infiltrated and degraded by leukocytes and disappeared by 5 days in mice and from all but 1 of 20 women by 11 days.


CONCLUSIONS
ePTFE is rapidly encapsulated by a non-adherent membrane resembling peritoneum while ORC is rapidly infiltrated and degraded by peritoneal fluid leukocytes.
Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA.
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Haney
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Doty
D000818:Animals; D002482:Cellulose; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D051379:Mice; D010084:Oxidation-Reduction; D010529:Peritoneal Cavity / Q000502:physiology*; D011138:Polytetrafluoroethylene / Q000494:pharmacology*; D011183:Postoperative Complications / Q000517:prevention & control*; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*
D011138:Polytetrafluoroethylene; D002482:Cellulose