[Modifications in the abdominal wall after prostheses implant in guinea pigs. Experimental preliminary study]

The treatment of giant incisional hernias is often not possible without the use of alloplastic materials (prostheses, meshes). Some of the modern prostheses seem to be quite "biocompatible" from the chemical point of view, but, the manner of using them is associated with certain complications (infection, seroma formation, intestinal obstruction, digestive fistula and failure of the repair). This preliminary experimental study on Guinea pigs had as a purpose the evaluation of the prostheses incorporation in the abdominal wall, the appearance of specific complications and the need of the biomaterial fixation. The macroscopic and microscopic study used 59 Guinea pigs, utilizing polypropylene (Marlex) and polyester (Mersilene and Plastex) prostheses, implanted pre-peritoneal and intraperitoneal, with or without fixation. The lack of incorporation of the prostheses was observed especially with the Plastex mesh (7 cases). Intestinal adhesions have been the rule after intraperitoneal implant of the prostheses; we registered a case of intestinal obstruction and a case of digestive fistula. Concluding, it is recommended the utilization of quality prostheses, especially polypropylene (Marlex) and no longer use of the Romanian polyester mesh (Plastex) which has obvious "biocompatible" problems. The intraperitoneal implant of the prostheses is not indicated. Adequate anchoring af the biomaterials prevents the subsequent migration.