Temporary closure of the abdomen using a new composite prosthesis (PL-PU99)

Background: Temporary abdominal wound closure is sometimes desirable when tension-free approximation of the wound edges is impractical or when reexploration is planned. Methods: The behavior of a composite prosthesis (PL-PU99) designed by our group was evaluated as a method of temporary abdominal closure in white New Zealand rabbits. After a 7 cm long midline laparotomy, a spindle-shaped 4 cm (maximum width) by 7 cm (length) fragment of PL-PU99 was sutured to the edges of the peritoneal, muscular, and fascial abdominal tissues, so that the biomaterial remained in contact with the exterior. The PL-PU99 composite is composed of a polypropylene mesh adhered to a sheet of polyurethane with an acrylic cement. At 7 and 14 days after implant, animals were sacrificed and specimens taken for morphological, ultrastructural, morphometry of the neoperitoneum, and immunohistochemical (macrophage reaction, RAM-11) analysis. Results: No death or signs of infection or rejection of the prostheses were recorded. No adhesions could be macroscopically ob. served between the composite and the intestinal loops. The biomaterial achieved a good seal, no leakage of fluids being detected. Fourteen days after implant, the neoperitoneum formed on the prosthesis was of An even structure and was made up of organized, vascularized connective tissue covered by an uninterrupted mesothelium. Conclusions: The PL-PU99 prosthesis shows optimal behavior at the prosthesis/visceral peritoneum interface, making it ideal for its use in the temporary closure of the abdomen. The implanted composite may also prove useful for the permanent repair of the abdominal wall. (C) 2004 Excerpta.Medica, Inc. All rights reserved.