Influence of the structure of new generation prostheses on shrinkage after implant in the abdominal wall.
When a biomaterial is used to repair an abdominal wall defect, wound contraction can cause the prosthesis to shrink, and the tension generated can provoke recurrence of the defect. This study was designed to determine whether the structure of a prosthesis can directly influence prosthetic shrinkage. Abdominal wall defects (7 x 5 cm) in rabbits were repaired using the laminar prosthesis DualMesh (DM), the composites Sepramesh (Se) and Vypro II (Vy), and the reticular prosthesis Surgipro (PP). The animals were sacrificed 14 and 90 days after surgery, at which time implant specimens were morphologically and immunohistochemically examined to establish the presence of myofibroblasts and macrophages. The size of each prosthesis was measured at the end of the study through image analysis. Morphometric measurements revealed greatest prosthesis shrinkage for Se, PP, and Vy (16.05% +/- 5.08%; 13.75% +/- 4.22%; 16.16% +/- 6.34%), while the DM prostheses only showed a 7.57% +/- 0.62% decrease in size (p < 0.05). In the DM implants, the macrophage response and myofibroblast labeling were reduced. Both biomaterial structure and the macrophage reaction induced at the implant site modulate prosthetic shrinkage, laminar prostheses of the ePTFE type undergoing less shrinkage than reticular meshes. Reduced DM shrinkage was linked to decreased myofibroblast numbers 2 weeks postimplant.
Department of Surgery, Faculty of Medicine, University of Alcalá, Ctra. N-II, Km 33.600, 28871 Alcalá de Henares, Madrid, Spain. juanm.bellon@uah.es
J M
JM
Bellón
N
N
García-Honduvilla
M
M
Rodríguez
G
G
Pascual
V
V
Gómez-Gil
J
J
Buján
D000007:Abdominal Injuries / Q000473:pathology / Q000601:surgery; D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery; D020341:Absorbable Implants; D000818:Animals; D020099:Coated Materials, Biocompatible / Q000009:adverse effects; D005347:Fibroblasts; D020007:Implants, Experimental; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D008422:Materials Testing; D011126:Polypropylenes / Q000009:adverse effects; D019919:Prosthesis Implantation; D011817:Rabbits; D013997:Time Factors
D020099:Coated Materials, Biocompatible; D011126:Polypropylenes; C418228:sepramesh