Interface formed between visceral peritoneum and experimental polypropylene or polytetrafluoroethylene abdominal wall implants

Abstract

The objective of this work was to study the healing process at the interface between biomaterial and visceral peritoneum. Implants of polytetrafluoroethylene (ePTFE) and polypropylene prostheses were introduced into the abdominal wall of New Zealand rabbits. The behaviour of the biomaterials was analysed using light and scanning electron microscopy and immunohistochemistry in which a specific anti-rabbit macrophage monoclonal antibody (RAM 11) was employed. According to macroscopic observation, there was significantly fewer adhesions prosthesis-viscera to ePTFE than to polypropylene implants. After ePTFE implantation, restoration of the peritoneum took place in an orderly fashion. When polypropylene was used, the peritoneum formed was a disorderly tissue in which small areas of haemorrhage and necrosis could be seen to coincide with the appearance of adhesions. The number of labelled macrophages peaked 14 days after ePTFE or polypropylene implantation, after which it decreased gradually. It is concluded that, given the low rate of adhesion provoked by PTFE, this material is ideal for implants contiguous to the peritoneal cavity viscera. The macrophage response does not determine the use of one material or the other. The structure of the newly formed peritoneum and development of adhesions depends on the porosity of the biomaterial.