The structure of a biomaterial rather than its chemical composition modulates the repair process at the peritoneal level

Background: This study was designed to establish whether the spatial structure of a prosthesis conditions its behavior at the peritoneal level. Methods: Abdominal defects comprising all,the wall (except skin) were created in rabbits and repaired with a laminar (DM) or reticular (CV-4) ePTFE-prosthesis. Fourteen days postimplant, specimens were obtained for scanning electron and light microscopy. Peritoneal adhesions, resistance to traction, and neoperitoneum thickness were quantified. Results: Adhesions to CV-4 were firm and integrated within surrounding tissue; only scarce adhesion formation was observed for DM. Adhesion area was significantly greater (P<0.01) in the CV-4 than in DM (7.00 +/- 2.6; 0.15 +/- 0.08 cm(2)). The neoperitoneum was organized for DM and disorganized for CV-4. This layer was significantly thicker (P<0.05) in DM than CV-4 (455+/-3.4; 70+/-3.1 mum). The CV-4 showed a greater resistance to traction than the DM (26.75+/-3.71; 14.11+/-3.71 N; P<0.05). Conclusions: The structure of a biomaterial, rather than its chemical composition, modulates behavior at the peritoneal interface. (C) 2002 Excerpta Medica, Inc. All rights reserved.