Antibiotic-enriched decellularized bovine pericardium for abdominal wall repair in rats: Evaluation of inflammatory response and mechanical strength

BACKGROUND: Abdominal wall defects represent a significant surgical challenge due to their potential for serious complications such as herniation, adhesion, and infection. Biomaterials have emerged as viable options for reconstruction, with biological membranes showing promising biocompatibility and reduced inflammatory responses compared to synthetic meshes. However, infection risk remains a major concern, especially due to biofilm formation on implanted materials. OBJECTIVE: This study aimed to evaluate the inflammatory response, biomechanical performance, and histological characteristics of decellularized bovine pericardium membranes-enriched with vancomycin or amikacin-in comparison to unenriched membranes and synthetic polypropylene mesh for abdominal wall repair in Wistar rats. METHODS: Sixty-four Wistar rats were randomly allocated into four groups (n=16 each): Group I received vancomycin-enriched membranes; Group II, amikacin-enriched membranes; Group III, unenriched decellularized membranes; and Group IV, polypropylene mesh. Animals were euthanized on postoperative days 7 and 21. Hematological analyses were performed, and macroscopic, biomechanical, and histological evaluations were conducted to assess inflammation, tensile strength, and tissue integration. RESULTS: Vancomycin and amikacin-enriched membranes showed reduced inflammatory infiltrates and better vascularized integration compared to the synthetic mesh group. Tensile strength was highest in the polypropylene group, but enriched biological membranes presented satisfactory mechanical resistance. Macroscopically, fewer adhesions were observed in Groups I and II. Histologically, Groups I and II demonstrated more organized tissue remodeling and reduced inflammatory markers. CONCLUSION: Decellularized bovine pericardium membranes enriched with antibiotics demonstrated similar integration, inflammation process, and adequate mechanical properties, making them a promising alternative to synthetic meshes in contaminated or infection-prone abdominal wall repairs.