Doxycycline alters collagen composition following ventral hernia repair

Zwitterion mediated anti-protein adsorption on polypropylene mesh to reduce inflammation for efficient hernia repair

The effectiveness of polypropylene (PP) mesh is often compromised by severe inflammation. Engineering anti-inflammatory coatings has significant implications for PP mesh to repair unwanted hernias. Here, we presented a facile strategy to develop an anti-fouling coating consisting of zwitterionic poly(carboxybetaine methacrylate) (PCBMA), which could prohibit protein adsorption to endow PP mesh with anti-inflammatory efficacy. The incorporation of PCBMA coating had little impact on the raw features of PP mesh. While the modified mesh PCBMA-PP possessed noticeable hydrophilicity increase and surface charge reduction. The excellent lubricity and surface stability enabled PCBMA-PP to exhibit superior anti-fouling capacity, thus efficiently inhibiting the adsorption of proteins. In vivo experiments showed that incorporating the PCBMA layer could provide PP meshes with outstanding anti-inflammatory effects and tissue compatibility for repairing hernias.

Preparation of Transdermal Patch Containing Selenium Nanoparticles Loaded with Doxycycline and Evaluation of Skin Wound Healing in a Rat Model

The present study aimed to prepare and evaluate a controlled-release system based on a chitosan scaffold containing selenium nanoparticles loaded with doxycycline. Its topical application in skin wound healing in rats was investigated. Therefore, 80 female rats were used and, after creating experimental skin defects on their back, were randomly divided into four equal groups: the control group without any therapeutic intervention; the second group received a chitosan transdermal patch (Ch); the third group received chitosan transdermal patch loaded with selenium nanoparticles (ChSeN), and the last group received chitosan transdermal patch containing selenium nanoparticle loaded by doxycycline (ChSeND). Morphological and structural characteristics of the synthesized patches were evaluated, and in addition to measuring the skin wound area on days 3, 7, and 21, a histopathological examination was performed. On the third day of the study, less hemorrhage and inflammation and more neo-vascularization were seen in the ChSeND group. Moreover, on day 7, less inflammation and collagen formation were recorded in the ChSeN and ChSeND groups than in the other groups. At the same time, more neo-vascularization and re-epithelialization were seen in the ChSeND group on days 7 and 21. In addition, on day 21 of the study, the most collagen formation was in this group. Examination of the wound area also showed that the lowest area belonged to the ChSeND group. The results showed that the simultaneous presence of selenium nanoparticles and doxycycline in the ChSeND group provided the best repair compared to the control, Ch and ChSeN groups.

Hernia Repair Strength Enhanced With Antioxidants

BACKGROUND

Incisional hernia is one of the most common complications of abdominal surgery, and repairs are associated with significant recurrence rates. Mesh repairs are associated with the best outcomes, but failures are not uncommon. Doxycycline has been demonstrated to enhance mesh hernia repair outcomes with associated increases in collagen deposition and improved tensiometric strength. This study compares the outcomes of incisional hernia repair with doxycycline administration and the antioxidant tempol.

MATERIALS AND METHODS

Twenty-eight male Sprague Dawley rats underwent a midline hernia creation and an intraabdominal polypropylene mesh repair. The animals were administered saline, doxycycline, tempol, or both, daily for 8 wk. The abdominal wall was harvested at 8 wk and tensiometric strength and biochemical analysis was performed.

RESULTS

The tensiometric strength of the repair was increased in all experimental groups. Collagen type 1 deposition was increased, and collagen type 3 deposition was decreased in each of the experimental groups relative to control. There was no difference in MMP-2 and MMP-9 levels between control and experimental groups.

CONCLUSIONS

The hernia repair strength is equally enhanced with the administration of doxycycline or tempol. Dual therapy provided no benefit over treatment with either single agent. All treatment groups had an increase in collagen type 1:3 ratios, but the mechanism is not well understood. The benefits of antioxidant treatment following hernia repair are similar to treatment with doxycycline. Given the high frequency of incisional hernia repair failures, this study has implications for improving outcomes following ventral hernia repair through the use of either doxycycline or antioxidant therapy.