OBJECTIVE
The study purpose was to evaluate the associations between patient characteristics or surgical site classifications and the histologic remodeling scores of biologic meshes biopsied from abdominal soft tissue repair sites in the first attempt to generate a multivariable risk prediction model of non-constructive remodeling.
INTRODUCTION
Host characteristics and surgical site assessments may predict remodeling degree for biologic meshes used to reinforce abdominal tissue repair sites.
METHODS
Biologic meshes were biopsied from the abdominal tissue repair sites of n=40 patients during an abdominal re-exploration, stained with hematoxylin and eosin, and evaluated according to a semi-quantitative scoring system for remodeling characteristics [cell types (CT), cell infiltration (CI), extracellular matrix (ECM) deposition, scaffold degradation (SD), fibrous encapsulation (FE), and neovascularization (NEO)] and a mean composite score (CR). Biopsies were stained with Sirius Red & Fast Green, and analyzed to determine the collagen I:III ratio. Based on univariate analyses between subject clinical characteristics or surgical site classification and the histologic remodeling scores, cohort variables were selected for multivariable regression models using a p-value ≤0.200.
RESULTS
The model selection process for CI score yielded 2 variables: age at mesh implantation and mesh classification (c-statistic=0.989). For CR score, the model selection process yielded 2 variables: age at mesh implantation and mesh classification (r2=0.449).
CONCLUSION
These preliminary results constitute the first steps in generating a risk prediction model that predicts the patients and clinical circumstances most likely to experience non-constructive remodeling of abdominal tissue repair sites with biologic mesh reinforcement.