Effect of phosphatidylcholine on the process of peritoneal adhesion following implantation of a polypropylene mesh prosthesis

The postimplantation peritoneal adhesions formed with some biomaterials continue to represent a serious problem when these biomaterials are placed in contact with the organs of the abdominal cavity. The objective was to test the effects of phosphatidylcholine (PC) in the attempt to modulate the adhesive process, thus improving the biomaterial/visceral peritoneum interface. We have carried out an experimental study using the New Zealand white rabbit, implanting a 7 x 5 cm(2) polypropylene prosthesis into the anterior abdominal wall in such a way that it replaced all the tissue layers and was in contact with the intestinal loops. Three study groups were established: group I (control), in which only implantation of the biomaterial was performed; group II, in which the prosthesis was pretreated with a solution of PC; and group III, in which the implants were treated as in group II and the animals underwent intraperitoneal administration of 10 ml of the same solution. The animals were killed on postimplantation day 14. The total surface of the prosthesis occupied by adhesions was measured and light and scanning electron microscopy were performed to analyse the healing process. In comparison with the controls, groups II and III did not present significant differences with respect to the resistance or extension of the adhesions. The microscopic results showed a rapid formation of disorderly and well-vascularised scar tissue enveloping the entire prosthesis. Thus, PC was unable to modulate the process of adhesion formation between the prosthesis and the organs of the abdominal cavity; nor did it induce changes in the cells of sufficient importance to alter the results of the healing process in the presence of this biomaterial. (C) 1996 Elsevier Science Limited