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Liu C, Lin Z, Ruan W, Gai X, Qu Q, Wang C, Zhu F, Sun X, Zhang J. Safety and tissue remodeling assay of small intestinal submucosa meshes using a modified porcine surgical hernia model. Sci Rep 2024; 13:23108. [PMID: 38172186 PMCID: PMC10764949 DOI: 10.1038/s41598-023-50425-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
In studies to date, meshes based on extracellular matrix (ECM) have been extensively used in clinical applications. Unfortunately, little is known about the function of the immunogenic residual, absorbable profile during the tissue repair process. Moreover, there needs to be a recognized preclinical animal model to investigate the safety and efficacy of extracellular matrix meshes. Herein, we designed and fabricated a kind of SIS mesh followed by a scanned electron micrograph characterization and tested α-Gal antigen clearance rate and DNA residual. In order to prove the biocompatibility of the SIS mesh, cell viability, chemotaxis assay and local tissue reaction were assessed by MTT and RTCA cytotoxicity test in vitro as well as implantation and degradation experiments in vivo. Furthermore, we developed a stable preclinical animal model in the porcine ventral hernia repair investigation, which using laparoscopic plus open hybridization method to evaluate tissue adhesion, explant mechanical performance, and histologic analysis after mesh implantation. More importantly, we established a semi-quantitative scoring system to examine the ECM degradation, tissue remodeling and regeneration in the modified porcine surgical hernia model for the first time. Our results highlight the application prospect of the improved porcine ventral hernia model for the safety and efficacy investigation of hernia repair meshes.
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Affiliation(s)
- Chenghu Liu
- Institute of Immunopharmacology and Immunotherapy, School of Pharmaceutical Sciences, Shandong University, 44 Wenhua Xi Rd, Jinan, 250012, Shandong, China
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, 250101, China
| | - Zhenhua Lin
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, 250101, China
| | - Wenting Ruan
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, 250101, China
| | - Xiaoxiao Gai
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, 250101, China
| | - Qiujin Qu
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, 250101, China
| | - Changbin Wang
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, 250101, China
| | - Fuyu Zhu
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, 250101, China
| | - Xiaoxia Sun
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, NMPA Key Laboratory for Safety Evaluation of Biomaterials and Medical Devices, Jinan, 250101, China
| | - Jian Zhang
- Institute of Immunopharmacology and Immunotherapy, School of Pharmaceutical Sciences, Shandong University, 44 Wenhua Xi Rd, Jinan, 250012, Shandong, China.
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Garcia DPC, Santos C, Nunes CB, Buzelin MA, Petroianu A, Figueiredo LOD, Motta ASD, Gaspar CDB, Alberti LR. Comparative study of intraperitoneal adhesions related to light-weight polypropylene mesh and type I polymerized and purified bovine collagen coated light-weight polypropylene mesh in rabbits. Acta Cir Bras 2017; 32:903-912. [PMID: 29236795 DOI: 10.1590/s0102-865020170110000002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/21/2017] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To compare the effectiveness of light-weight polypropylene mesh coated with polymerized and purified bovine type I collagen (Surgidry HNB) in the treatment of abdominal wall defect and the degree of adhesion formation. METHODS Two types of polypropylene mesh were implanted after creation of defect measuring 6.0cm X 5.5cm in the anterior abdominal wall of 32 male New Zealand breed rabbits, divided in two groups (n = 32): (1) light-weigh macroporous polypropylene, (2) type I polymerized and purified bovine collagen coated light-weigh macroporous polypropylene. These animals were further accessed for adhesions, histological evaluation of inflammation and wall's thickness. RESULTS The percentage of the area adhered in group 1 (62.31 ± 16.6) was higher compared to group 2 (22.19 ± 14.57) (p <0.05). There was an association between the percentage of the covered area by adhesions and the type of adhesion, toughness and the scores obtained by the adhesion score by correlation analysis (p <0.05). There was no difference between the groups in any variables in relation to the degree of inflammation. CONCLUSION The purified type I bovine collagen coated light-weigh polypropylene mesh showed to be effective in the repair of abdominal wall defects and reducing adhesion formation.
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Affiliation(s)
- Diego Paim Carvalho Garcia
- PhD, Associate Professor, Department of Surgery, Instituto de Ensino e Pesquisa da Santa Casa, Belo Horizonte-MG, Brazil. Intellectual and scientific content of the study, design the protocol, technical procedures, manuscript writing
| | - Clarissa Santos
- MD, Hospital Universitário São José, Belo Horizonte-MG, Brazil. Acquisition and interpretation of data, statistical analysis, design the protocol, technical procedures, macroscopic and histopathological examinations
| | - Cristiana Buzelin Nunes
- PhD, Assistant Professor, Department of Pathology, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte-MG, Brazil. Technical procedures, macroscopic and histopathological examinations, interpretation of data
| | - Marcelo Araújo Buzelin
- Biologist, Master in Pathology, Instituto de Ensino e Pesquisa da Santa Casa, Belo Horizonte-MG, Brazil. Technical procedures, macroscopic and histopathological examinations, interpretation of data
| | - Andy Petroianu
- PhD, Full Professor, Department of Surgery, School of Medicine, UFMG, Belo Horizonte-MG, Brazil. Intellectual and scientific content of the study, design the protocol, provided guidelines for the surgical interventions, supervised all phases of the study
| | - Luiza Ohasi de Figueiredo
- MD, Hospital Felício Rocho, and Fellow of Oncologic Surgery, Hospital Alberto Cavalcanti, Belo Horizonte-MG, Brazil. Acquisition and interpretation of data, statistical analysis, manuscript preparation
| | - Andreia Souto da Motta
- MD, Fellow of Plastic Surgery, Hospital Felício Rocho, Belo Horizonte-MG, Brazil Acquisition and interpretation of data, statistical analysis, manuscript preparation
| | - Cristiane de Barros Gaspar
- MD, Fellow of Plastic Surgery, Hospital Felício Rocho, Belo Horizonte-MG, Brazil Acquisition and interpretation of data, statistical analysis, manuscript preparation
| | - Luiz Ronaldo Alberti
- PhD, Associate Professor, Department of Surgery, School of Medicine, UFMG, and Instituto de Ensino e Pesquisa da Santa Casa, Belo Horizonte-MG, Brazil. Acquisition and interpretation of data, statistical analysis, design the protocol, technical procedures
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Kelly M, Macdougall K, Olabisi O, McGuire N. In vivo response to polypropylene following implantation in animal models: a review of biocompatibility. Int Urogynecol J 2016; 28:171-180. [PMID: 27216918 PMCID: PMC5306078 DOI: 10.1007/s00192-016-3029-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 04/17/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Polypropylene is a material that is commonly used to treat pelvic floor conditions such as pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Owing to the nature of complications experienced by some patients implanted with either incontinence or prolapse meshes, the biocompatibility of polypropylene has recently been questioned. This literature review considers the in vivo response to polypropylene following implantation in animal models. The specific areas explored in this review are material selection, impact of anatomical location, and the structure, weight and size of polypropylene mesh types. METHODS All relevant abstracts from original articles investigating the host response of mesh in vivo were reviewed. Papers were obtained and categorised into various mesh material types: polypropylene, polypropylene composites, and other synthetic and biologically derived mesh. RESULTS Polypropylene mesh fared well in comparison with other material types in terms of host response. It was found that a lightweight, large-pore mesh is the most appropriate structure. CONCLUSION The evidence reviewed shows that polypropylene evokes a less inflammatory or similar host response when compared with other materials used in mesh devices.
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Affiliation(s)
- Michelle Kelly
- Devices Division, The Medicines and Healthcare products Regulatory Agency (MHRA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK
| | - Katherine Macdougall
- Devices Division, The Medicines and Healthcare products Regulatory Agency (MHRA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK
| | - Oluwafisayo Olabisi
- Devices Division, The Medicines and Healthcare products Regulatory Agency (MHRA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK.
| | - Neil McGuire
- Devices Division, The Medicines and Healthcare products Regulatory Agency (MHRA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK
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Ramakrishna HK, Lakshman K. Intra Peritoneal Polypropylene Mesh and Newer Meshes in Ventral Hernia Repair: What EBM Says? Indian J Surg 2012; 75:346-51. [PMID: 24426474 DOI: 10.1007/s12262-012-0743-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022] Open
Abstract
Incisional hernias and other ventral hernias are common surgical problems. It is estimated that incisional hernia complicates about 2 % to 10 % of laparotomies. Ventral and incisional hernia repairs are among the common surgeries done by a general surgeon. It is proven beyond any doubt that suture repair of these hernias should not be done as recurrence rates are unacceptably high, some series reporting as high as 54 % on long-term follow-up. A prosthetic mesh should always be used in ventral hernia repair (VHR). Now, the polypropylene mesh (PPM) has become the prosthetic mesh of choice in the repair of hernias, including inguinal hernia. However, with the advent of laparoscopic repair where the mesh is placed intraperitoneally, concerns regarding safety of PPM are raised. Newer meshes are introduced, claiming lesser complication rate. Many types of newer meshes are available now. Newer meshes are invariably costlier than PPM by 15-20 times. Is this extra cost worth? We looked in to available literature for an answer.
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Affiliation(s)
- H K Ramakrishna
- Lakshmi Nursing Home, New Bridge Road, Bhadravathi, 577301 India
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