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Long term comparative evaluation of two types of absorbable meshes in partial abdominal wall defects: an experimental study in rabbits

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Abstract

Purpose

Synthetic prosthetic materials that are fully absorbable seek to reduce the host foreign body reaction and promote host tissue regeneration. This preclinical trial was designed to analyse, in the long term, the behaviour of two prosthetic meshes, one synthetic and one composed of porcine collagen, in abdominal wall reconstruction.

Methods

Partial defects were created in the abdominal walls of New Zealand rabbits and repaired using a synthetic absorbable mesh (Phasix™) or a non-crosslinked collagen bioprosthesis (Protexa™). After 3, 6, 12 and 18 months, specimens were recovered for light microscopy and collagen expression analysis to examine new host tissue incorporation, macrophage response and biomechanical strength.

Results

Both materials showed good host tissue incorporation in line with their spatial structure. At 18 months postimplant, Protexa™ was highly reabsorbed while the biodegradation of Phasix™ was still incomplete. Collagenization of both materials was good. Macrophage counts steadily decreased over time in response to Phasix™, yet persisted in the collagen meshes. At 18 months, zones of loose tissue were observed at the implant site in the absence of herniation in both implant types. The stress–stretch behaviour of Phasix™ implants decreased over time, being more pronounced during the period of 12–18 months. Nevertheless, the abdominal wall repaired with Protexa™ became stiffer over time.

Conclusion

Eighteen months after the implant both materials showed good compatibility but the biodegradation of Phasix™ and Protexa™ was incomplete. No signs of hernia were observed at 18 months with the stress–stretch relations being similar for both implants, regardless of the more compliant abdominal wall repaired with Protexa™ at short term.

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Acknowledgements

The study was supported by Grant “SAF2017-89481-P” from the Spanish Ministry of Economy and Competitiveness.

Author information

Author notes

  1. F. García-Moreno and Juan M. Bellón contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá. Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain

    G. Pascual & B. Pérez-Köhler

  2. Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá. Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain

    M. Rodríguez, S. Benito-Martínez, F. García-Moreno & J. M. Bellón

  3. Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain

    B. Calvo

  4. Networking Biomedical Research Centre on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain

    G. Pascual, M. Rodríguez, B. Pérez-Köhler, S. Benito-Martínez, B. Calvo, F. García-Moreno & J. M. Bellón

Authors
  1. G. Pascual
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  2. M. Rodríguez
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Corresponding author

Correspondence to J. M. Bellón.

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Conflict of interest

We have no conflicts of interest to disclose.

Ethical approval

The study protocol was approved by the Committee on the Ethics of Animal Experiments of the Universidad de Alcalá, Madrid, Spain.The study protocol was approved by the Committee on the Ethics of Animal Experiments of the Universidad de Alcalá, Madrid, Spain.

Human and animal rights

The up-keep and handling of animals throughout the study was in accordance with the Guide for the Care and Use of Laboratory Animals of the National and European Institutes of Health (Spanish Law 6/2013, Spanish Royal Decree 53/2013, European Directive 2010/63/UE and European Convention of the Council of Europe ETS123). All procedures were performed at the Animal Research Centre of the Universidad de Alcalá (Madrid, Spain), which is registered with the Directorate General for Agriculture of the Ministry of Economy and Technology Innovation of the Community of Madrid (ES280050001165) ensuring all facilities legally cover the needs and requirements of the research.

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Pascual, G., Rodríguez, M., Pérez-Köhler, B. et al. Long term comparative evaluation of two types of absorbable meshes in partial abdominal wall defects: an experimental study in rabbits. Hernia 24, 1159–1173 (2020). https://doi.org/10.1007/s10029-020-02201-x

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  • DOI: https://doi.org/10.1007/s10029-020-02201-x

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