Porcine incisional hernia model: Evaluation of biologically derived intact extracellular matrix repairs

Abstract

We compared fascial wounds repaired with non-cross-linked intact porcine-derived acellular dermal matrix versus primary closure in a large-animal hernia model. Incisional hernias were created in Yucatan pigs and repaired after 3 weeks via open technique with suture-only primary closure or intraperitoneally placed porcine-derived acellular dermal matrix. Progressive changes in mechanical and biological properties of porcine-derived acellular dermal matrix and repair sites were assessed. Porcine-derived acellular dermal matrix–repaired hernias of additional animals were evaluated 2 and 4 weeks post incision to assess porcine-derived acellular dermal matrix regenerative potential and biomechanical changes. Hernias repaired with primary closure showed substantially more scarring and bone hyperplasia along the incision line. Mechanical remodeling of porcine-derived acellular dermal matrix was noted over time. Porcine-derived acellular dermal matrix elastic modulus and ultimate tensile stress were similar to fascia at 6 weeks. The biology of porcine-derived acellular dermal matrix–reinforced animals was more similar to native abdominal wall versus that with primary closure. In this study, porcine-derived acellular dermal matrix–reinforced repairs provided more complete wound healing response compared with primary closure.

Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair

“…The results of this study compare well with similar, previously published studies [ 24 , 25 , 27 , 32 ]. In 2013, Deeken et al evaluated Phasix™ in a porcine model of hernia repair at 6, 12, 26, and 52 weeks postimplantation.…”

“…In a third study, Monteiro et al evaluated Strattice™ in a porcine model at 2, 4, and 6 weeks postimplantation. These results were also comparable to the results of Strattice™ in the current study and showed a mild inflammatory response with rapid 40, 84, and 81 % decline in mesh strength at 2, 4, and 6 weeks, respectively [ 27 ].…”

“…These biologically derived scaffold observations are similar to previously reported results by Cavallo et al that demonstrated 91 % and 96 % lower mechanical strength for biologically derived (Strattice™) mesh/repairs relative to preimplantation strength at 1 and 6 months, respectively [ 19 , 26 ]. Similarly, Monteiro et al also showed a 40, 84, and 81 % reduction in mechanical strength for Strattice™ mesh/repairs relative to preimplantation strength at 2, 4, and 6 weeks, respectively [ 27 ]. However, it should be noted that in the current study, the strength of Strattice™ mesh/tissue repairs at both 12 and 24 weeks was still approximately 3 times the strength of NAW alone.…”

Hemogram dan Respon Jaringan Hernia Insisional Babi Pascaterapi Mesh Bedah Polipropilen dengan atau tanpa Asam Hyaluronat

“…Hernia abdominalis dapat diperbaiki dengan cara penjahitan atau dengan bantuan mesh bedah (Monteiro et al, 2013). Penggunaan metode jahitan sebagai terapi primer maupun sekunder sering menimbulkan kejadian berulang pada hernia abdominalis (Doctor, 2006).…”

Biomaterials and structural fat grafting

“…The enzymatic processing of Strattice significantly reduces the amount of α-Gal epitope in the absence of damage to the matrix integrity (collagen and elastin architecture). 69 Clinically, Strattice may enhance soft-tissue support in patients with poor-quality mammary soft-tissue support, especially in implant-based breast reconstruction post mastectomy and in certain patients undergoing augmentation mammoplasty. The tissue matrix is provided in two forms -pliable and firm.…”