Revascularization of Human Acellular Dermis in Full-Thickness Abdominal Wall Reconstruction in the Rabbit Model

Menon, Nathan G.; Rodriguez, Eduardo D.; Byrnes, Colman K.; Girotto, John A.; Goldberg, Nelson H.; Silverman, Ronald P.

doi:10.1097/01.sap.0000044252.76804.6b

Cited by 222 publications

(122 citation statements)

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“…Although propylene mesh has been used for abdominal hernia repair, untoward effects such as formation of a fibrotic capsule and discomfort due to the resulting stiffness have remained as a problem [37]. Consequently, acellular biomaterials derived from tissues have been suggested as an alternative to polypropylene mesh in abdominal fascial repair surgery [15,6,16]. In this study, we tested a collagen-based matrix processed from porcine bladder in a rabbit abdominal hernia model.…”

Section: Discussionmentioning

confidence: 99%

“…Further, the resulting fibrous layer does not resemble normal facial tissue. As such, naturally derived processed tissue matrices, such as bovine pericardium or other acellular matrices, have been investigated due to their excellent biocompatibility [15,6,16].…”

Section: Introductionmentioning

confidence: 99%

“…An ideal biomaterial for fascial tissue repair should be biocompatible, promote new tissue formation, elicit minimal inflammation and be able to withstand sufficient tensile forces in order to maintain structural integrity in vivo [2,3,6]. Although synthetic materials, such as polypropylene mesh, have been used to match the required tensile strength for fascial tissue substitute, these materials are frequently associated with untoward effects such as fibrotic encapsulation, infection, erosion, bowel adhesion and mesh extrusion [7-11, 4, 12-14].…”

Section: Introductionmentioning

confidence: 99%

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One and four layer acellular bladder matrix for fascial tissue reconstruction

Eberli

Atala

Yoo

2011

J Mater Sci: Mater Med

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To determine whether the use of multiple layers of acellular bladder matrix (ABM) is more suitable for the treatment of abdominal wall hernia than a single layered ABM. The feasibility, biocompatibility and mechanical properties of both materials were assessed and compared. Biocompatibility testing was performed on 4 and 1 layered ABM. The matrices were used to repair an abdominal hernia model in 24 rabbits. The animals were followed for up to 3 months. Immediately after euthanasia, the implant site was inspected and samples were retrieved for histology, scanning electron microscopy and biomechanical studies. Both acellular biomaterials demonstrated excellent biocompatibility. At the time of retrieval, there was no evidence of infection. The matrices demonstrated biomechanical properties comparable to native tissue. Three hernias (25%) were found in the single layer ABM group and only 1 hernia (8%) was found in the 4 layer ABM group. Histologically, the matrix structure was intact and the cell density within the matrices decreased with time. The dominant cell type present within the matrices shifted from lymphocytes to fibroblasts over time. Both ABMs maintained adequate strength over time when used for hernia repair, and there was an extremely low incidence of adhesion formation. The single layer ABM showed enhanced cellular integration, while the 4 layer ABM reduced hernia formation. Either of these matrices may be useful as an off-the-shelf biomaterial for patients requiring fascial repair. TITLE:ONE To determine whether the use of multiple layers of acellular bladder matrix (ABM) is more suitable for the treatment of abdominal wall hernia than a single layered ABM. The feasibility, biocompatibility and mechanical properties of both materials were assessed and compared.Design and Method: Biocompatibility testing was performed on 4 and 1 layered ABM.The matrices were used to repair an abdominal hernia model in 24 rabbits. The animals were followed for up to 3 months. Immediately after euthanasia, the implant site was inspected and samples were retrieved for histology, scanning electron microscopy and biomechanical studies.Results: Both acellular biomaterials demonstrated excellent biocompatibility. At the time of retrieval, there was no evidence of infection. The matrices demonstrated biomechanical properties comparable to native tissue. Three hernias (25%) were found in the single layer ABM group and only 1 hernia (8%) was found in the 4 layer ABM group.Histologically, the matrix structure was intact and the cell density within the matrices decreased with time. The dominant cell type present within the matrices shifted from lymphocytes to fibroblasts over time.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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One and four layer acellular bladder matrix for fascial tissue reconstruction

Eberli

Atala

Yoo

2011

J Mater Sci: Mater Med

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“…Although a wide variety of biological (21)(22)(23) and synthetic (1,24,25) matrices have been evaluated for their efficacy in tissue repair, their use is limited because of the lack of a blood supply, leading to their necrosis, infection, or possible rejection. In parallel, contemporary surgical techniques exploiting local, regional, or free flaps present disadvantages, such as donor site morbidity, procedure duration, the often scant availability of tissues in the area of the defects, and a requirement for higher surgical skill.…”

Section: Discussionmentioning

confidence: 99%

An engineered muscle flap for reconstruction of large soft tissue defects

Shandalov¹,

Egozi

Koffler

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

133

135

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Significance Effective restoration of large soft tissue defects requires the use of tissue flaps, with viability that is largely determined by degree of vascularization. In view of the tedious transfer procedures and donor site morbidity associated with autologous flaps, this work set out to design and evaluate an engineered muscle flap featuring a robust vascular port formed from preseeded endothelial cells and host vasculature. The implanted flap was highly vascularized, well-perfused, and anastomosed with host vessels. Engineered flaps of this nature promise to circumvent the need to harvest and transfer massive tissue volumes, while avoiding the consequential complications.

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“…Complete preservation of the extracellular matrix and progressive blood supply reconstruction allow the material to keep its own structure and differentiate into autologous tissue at the same time. An animal model has proven that early blood supply reconstruction increases the anti-infective properties of the implanted material (Menon et al, 2003). Therefore, the most important advantage of acellular dermal matrix is a high tolerance of infection around the site without a decrease in tensile strength.…”

Section: Discussionmentioning

confidence: 99%