Fate of collagen-based implants used in pelvic floor surgery: A 2-year follow-up study in a rabbit model

Claerhout, Filip; Verbist, Godelieve; Verbeken, Eric; Konstantinovic, Maja; Ridder, Dirk De; Deprest, Jan

doi:10.1016/j.ajog.2007.05.032

Cited by 43 publications

(34 citation statements)

References 25 publications

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“…This is not without an impact on strength, as non-degraded Pelvicol implants are twice as strong as degraded Pelvicol implants of similar thickness (234. 4 Occasional degradation is in accordance with earlier experiments by Claerhout et al [18] and clinical experience [25] , and has remained unexplained so far. Possible 'local' factors such as infection or a poor batch quality were considered.…”

Section: Discussionsupporting

confidence: 76%

“…Adhesions were preferentially to the suture line, and if extending beyond that, the pores became typically involved. In this model it looks as if pores larger than 0.4 mm in diameter get filled with omentum when implants are placed uncovered in the peritoneal cavity and this might be different in higher species [18,32] . Although the extent of adhesions cannot be compared to that seen following polypropylene implants [5] , the relevance of their occurrence should not be underestimated.…”

Section: Discussionmentioning

confidence: 99%

“…The former surgical area was resected 'en bloc' including: (1) the initial implant; (2) the interface, and (3) 2 cm of the neighboring native tissue, hereafter referred to as 'explant'. During resection the presence of adhesions was scored together with their extent and density scored according earlier publications [5,18,19] . At sacrifice several measurements were made: (1) implant thickness (mm) which was the average of three random measurements over the central part of the implant in areas devoid of pores (accuracy 0.01 mm), and (2) implant surface (cm 2 ) enabling calculation of a change in surface compared to baseline ((size sacrifice -size implantation )/size implantation ) !…”

Section: Methodsmentioning

confidence: 99%

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Porous Acellular Porcine Dermal Collagen Implants to Repair Fascial Defects in a Rat Model: Biomechanical Evaluation up to 180 Days

Ozog¹,

Konstantinovic²,

Zheng³

et al. 2009

Gynecol Obstet Invest

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Aim: To investigate the biomechanical properties of porous collagen matrices in a rat abdominal wall defect model. Study Design: 112 rats were implanted with non-cross-linked InteXèn LP, cross-linked Pelvicol, and two investigational acellular collagen matrices (ACMs) sterilized either with ethylene oxide (ACM ETO) or γ-irradiation (ACM GI). After 14, 30, 90 and 180 days, 7 animals per group were sacrificed to document adhesions, herniation, infection, stress resistance and histology. Results: The 2 sterilization methods did not cause measurable differences between ACMs. Pelvicol was more resistant than ACMs but showed degradation at 90 days without loss of strength. InteXèn LP became remodeled as a thin fibrous scar and was more resistant at all time points; however, some animals developed bulging. Conclusions: Non-cross-linked InteXèn LP became remodeled by 180 days with remarkable stress resistance. Despite cross-linking Pelvicol showed degradation. Comparable but investigational ACM explants were less resistant without morphologic differences to explain this.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Porous Acellular Porcine Dermal Collagen Implants to Repair Fascial Defects in a Rat Model: Biomechanical Evaluation up to 180 Days

Ozog¹,

Konstantinovic²,

Zheng³

et al. 2009

Gynecol Obstet Invest

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“…Thirty days after implantation in the human ADM group, there was an obvious chronic inflammatory reaction, indicating that heterogenic mesh rejection occurred, and 90 days after implantation the inflammatory reactive cellular infiltration was remarkably less. Claerhout et al [13] implanted porcine ADM mesh into rabbit abdominal walls, and observed implantation reactions for 2 years. In that study, the mesh was removed 30, 60, 90, 180, 360, 540, and 720 days after implantation and chronic inflammatory reactions around the mesh began to decrease 30 days after implantation, similar to what was observed in this study.…”

Section: Discussionmentioning

confidence: 99%

“…affect the host response to the biological graft, and hence the outcome of repair [11,13,14] . In addition, differences in host response, and thus quality of the repair, may also be present with the use of allogeneic versus heterogenic graft material (e.g., human versus porcine ADM used for human pelvic floor reconstruction).…”

mentioning

confidence: 99%

Tissue Reactions to Heterogenic and Allogeneic Acellular Dermal Matrix Mesh Placed in the Vesicovaginal Space in a Rabbit Model

Yao

Zhang

Han

et al. 2016

Gynecol Obstet Invest

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Background and Aim: This study is aimed at investigating the tissue reactions of heterogenic and allogeneic acellular dermal matrix (ADM) mesh implanted in the vesicovaginal space in a rabbit model. Methods: Twenty eight rabbits were implanted with heterogenic or allogeneic mesh, respectively, in the vesicovaginal space, and 4 served as the no-implantation control group. Rabbits were sacrificed at 7, 30, and 90 days after implantation. Histopathological study and immunohistochemical examination for collagen were performed. Results: Heterogenic but not allogeneic mesh was identifiable at 90 days. In the allogeneic group, neovascularization was observed from day 7 after implantation. A chronic inflammatory reaction was noted in the heterogenic group at 30 days that decreased at 90 days. Inflammation was less in the allogeneic group, but giant cells and fibroblasts were present. With respect to collagen, the heterogenic mesh remained structurally unchanged at 90 days, while new collagen fibers were observed in the allogeneic group from day 7. Conclusion: The immunological outcomes of heterogenic and allogeneic ADM mesh are different. Heterogenic mesh induces a chronic inflammatory reaction at day 30 after implantation, and maintains its original form longer. Allogeneic mesh is associated with new collagen generation, but degrades earlier.

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Mechanical properties of cross‐linked collagen meshes after human adipose derived stromal cells seeding

Ochoa

Peña

Andreu

et al. 2010

J Biomedical Materials Res

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The main goal of this study was to evaluate the potential of collagen meshes derived from porcine dermis as scaffolds for repairing pelvic organ prolapses. Mechanical properties of collagen meshes with different cross-linking percentages before and after Adipose Derived Stromal Cells (ADSC) seeding were studied as well as the cell-scaffold interaction. Uniaxial tensile tests of the collagen meshes with three different cross-linking percentages (full-, partial-, and noncross-linked) were carried out along orthogonal directions. Their mechanical properties were studied with the same tests before and after seeding with human derived adipose stem cells (ADSC) after 1 and 7 days. Histological analyses were performed to determine adhesion and proliferation of ADSC. Significant differences in mechanical properties of the unseeded meshes were observed between each orthogonal direction independently of the cross-linking percentage. A better cell adhesion rate was observed in the cross-linked meshes. An increase in the mechanical properties after cell seeding was observed with a direct relation with the degree of cross-linking. All meshes analyzed showed a marked anisotropy that should be taken into account during the surgical procedure. The cross-linking treatment increased cell adhesion and the mechanical properties of the collagen meshes after seeding. These results suggest that the mechanical properties of this type of collagen mesh could be useful as scaffolds for repair of pelvic organ prolapse.

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Fate of collagen-based implants used in pelvic floor surgery: A 2-year follow-up study in a rabbit model

Cited by 43 publications

References 25 publications

Porous Acellular Porcine Dermal Collagen Implants to Repair Fascial Defects in a Rat Model: Biomechanical Evaluation up to 180 Days

Porous Acellular Porcine Dermal Collagen Implants to Repair Fascial Defects in a Rat Model: Biomechanical Evaluation up to 180 Days

Tissue Reactions to Heterogenic and Allogeneic Acellular Dermal Matrix Mesh Placed in the Vesicovaginal Space in a Rabbit Model

Mechanical properties of cross‐linked collagen meshes after human adipose derived stromal cells seeding

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