Extracellular bovine-derived peritoneum matrix: evaluation of a new biological implant for abdominal wall reconstruction under bacterial contamination in an in vivo experimental model

Introduction: Modern herniology relies heavily on synthetic mesh prostheses, which have markedly reduced recurrence rates and improved outcomes. However, the use of tension-free repair in infected or highly contaminated fields remains insufficiently studied. Biologic implants based on the extracellular matrix (ECM) may attenuate the inflammatory response and reduce the risk of infection. This study evaluates the behavior of different implant types under experimental bacterial contamination.
Materials and methods: Three implants were investigated: an extracellular bovine-derived peritoneum matrix, preserved dura mater (DM), and the composite mesh prosthesis UltraPro. The study was conducted on 78 rats. After the creation of a standardized anterior abdominal wall defect, the defect was repaired using one of the studied implants and subsequently inoculated with MRSA or E. coli. Animals were observed for 10 and 20 days. Microbiological, immunological (circulating immune complexes), hematological, and macroscopic parameters were evaluated.
Results: MRSA contamination induced a pronounced local inflammatory response, including abscess formation on day 10, whereas E. coli was rapidly cleared from the implantation zone. No statistically significant differences in MRSA persistence or semi-quantitative titers were observed between ECM, UltraPro, and DM. Systemically, CIC patterns and hematological changes were similar between ECM and UltraPro, while DM—particularly under MRSA contamination—was associated with a more pronounced inflammatory response.
Conclusions: Under conditions of experimental bacterial contamination, the extracellular bovine-derived peritoneum matrix demonstrated local and systemic inflammatory profiles comparable to those of the synthetic UltraPro mesh and more favorable than those of preserved dura mater. All implants elicited a controlled inflammatory reaction without evidence of systemic septic complications. These findings support further research, including clinical trials, on the use of extracellular bovine-derived peritoneum matrix for reconstructive surgery of anterior abdominal wall defects in contaminated and potentially contaminated fields.