Implantes de prótesis laminares poliméricas y prótesis de colágeno biodegradables en defectos de pared abdominalestudio del proceso regenerativo tisular y del comportamiento mecánico

Abstract

In recent years, we have witnessed a rise in the use of biomaterials both as tissue substitutes and for tissue repair. Indeed, the excellent biocompatibility of today's prosthetic materials has led to their generalized use in the treatment of a ventral hernia or abdominal wall defect. The most common complications of the implant of a prosthetic material are infection, chronic pain or recurrence of the repaired defect. These complications, especially chronic pain or recurrence, generate healthcare costs arising from numerous appointments with specialized physicians, and the fact that patients often require further surgery to resolve their symptoms. Currently, new biological prosthetic meshes exist derived from animals or human cadavers. These materials are considered the prosthetics of choice but only in selected cases such as in a contaminated surgical field or in the repair of a large aponeurotic defect. An important feature of these biomaterials is that they act as a scaffold guiding tissue repair processes but are subsequently reabsorbed so that no foreign material persists in the host. Therefore, the success of this type of repair will depend on the correct balance between the host tissue repair process itself and the absorption, or degradation, of the implanted mesh. This will avoid the presence of a foreign body as in the case of a non-absorbable mesh, which may lead to chronic pain considerably reducing patient quality of life. The present PhD thesis was designed to examine both the intraperitoneal and extraperitoneal behaviour of three absorbable prosthetic materials: BIO-A® (BioA), Tutomesh® (Tuto) and Stattice® (St).