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

Objective: Currently, the choice of chest watt 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 watt 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 watt 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 watt repair. The advantages of biodegradable copolymer give them promise as an excellent addition to the available reconstructive techniques currently in use. (C) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.