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Chest wall reconstruction with two types of biodegradable polymer prostheses in dogs

Department of Thoracic Surgery, Chang Zheng Hospital, 2nd Military Medical University, Shanghai, China

Received 28 January 2008; received in revised form 24 May 2008; accepted 9 June 2008.

^_* Corresponding author. Tel.: +86 216 3610109x73351; fax: +86 216 3519824. (Email: xu_zhi_fei{at}yahoo.com.cn).

Objective: Currently, the choice of chest wall prosthesis remains a challenging problem for thoracic and reconstructive surgeons. The purpose of this study is to investigate the feasibility of newly developed biodegradable prostheses. Methods: Two types of chest wall prostheses made from degradable polymer, collagen coated polydioxanone (CCP) mesh and chitin fiber reinforced polycaprolactone (CFRP) strut, were developed and studied. Adult mongrel dogs were subjected to extensive resection and reconstruction of anterior-lateral chest wall, CCP mesh was used in six dogs, the combination of CCP mesh and CFRP strut was used in four dogs, and polypropylene (PP) mesh in two dogs, as contrast. Results: With good integration with tissue, CCP meshes maintained strength in the chest wall for more than 8 weeks and were completely resorbed within 24 weeks, and satisfactory short-term and long-term chest wall stabilization was achieved. The combined use of CCP mesh with CFRP strut provided a firmer chest wall in the early postoperative course. A mild wound infection developed in one animal with CCP mesh but resolved without sequelae, and no added complications were observed with the additional use of CFRP strut. Conclusions: Our experimental study shows that the CCP mesh and CFRP prosthesis were favorable for chest wall repair. The advantages of biodegradable copolymer give them promise as an excellent addition to the available reconstructive techniques currently in use.

Key Words: Biocompatible materials • Thoracic wall • Reconstructive surgical procedures