Evaluation of the histological and biomechanical properties of poly-4-hydroxybutyrate scaffold for pelvic organ prolapse, compared with polypropylene mesh in a rabbit model

Evaluation of the short‐term host response and biomechanics of an absorbable poly‐4‐hydroxybutyrate scaffold in a sheep model following vaginal implantation

“…The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) has recommended the identification of alternatives to PP, with a focus on biodegradable biomaterials to reduce the risk of long-term complications. 9 Poly-4-hydroxybutyrate (P4HB) has been identified as a candidate material for vaginal POP surgery, 10,11 with the hypothesis that a delayed absorbable scaffold will provide mechanical support while being gradually replaced by functional connective tissue. P4HB is a biologically produced biosynthetic polymer 12 that degrades to the human metabolite 4HB 13 before being eliminated from the body completely.…”

“…Poly‐4‐hydroxybutyrate (P4HB) has been identified as a candidate material for vaginal POP surgery, 10,11 with the hypothesis that a delayed absorbable scaffold will provide mechanical support while being gradually replaced by functional connective tissue. P4HB is a biologically produced biosynthetic polymer 12 that degrades to the human metabolite 4HB 13 before being eliminated from the body completely.…”

Fully resorbable poly-4-hydroxybutyrate (P4HB) mesh for soft tissue repair and reconstruction: A scoping review

“…Fourteen publications identified by this scoping review involved preclinical studies in a variety of animal models and species, including pigs, rats, rabbits, sheep, mice, and vervets (Figure 2, and Table 1) (6,23,24,26,36,37,(43)(44)(45)(46)(47)(48)(49)89). Three of these studies (n = 3) contained both a benchtop component and a preclinical component (6,36,37).…”

“…In the area of plastic and reconstructive surgery, P4HB mesh has been used primarily in breast surgery (13)(14)(15)(16)(17)(18)(19)(20)(21), with some early work in rhytidectomy (16,22). P4HB mesh has also been evaluated as a potential biomaterial for the repair of pelvic organ prolapse in urogynecological surgery (23)(24)(25)(26). The majority of data and clinical research using P4HB mesh has focused on general surgery applications, particularly in the area of hernia repair (i.e., ventral/incisional hernia, incisional hernia prophylaxis, inguinal hernia, and hiatal/paraesophageal hernia) (27)(28)(29)(30)(31).…”

The impact of bacterial contamination on the host response towards fully absorbable poly-4-hydroxybutyrate and nonabsorbable polypropylene pelvic floor implants

“…Previous research in other animal models showed varying results. In a sheep model P4HB demonstrated increased inflammation and decreased vascularization as compared to PP at 60 and 180 days [ 25 ], whereas in a rabbit model no significant differences were found after 3 and 9 months for inflammation, neovascularization and elastin and collagen deposition around both materials [ 48 ].…”