Abstract

ObjectiveThe purpose of this study was to compare the mechanical properties, host responses and incorporation of porcine small intestine submucosa (PSIS) and porcine acellular dermal matrix (PADM) in a rat model of abdominal wall defect repair.Materials and MethodsPrior to implantation, PSIS and PADM were prepared and evaluated in terms of structure and mechanical properties. Full-thickness abdominal wall defects were created in 50 Sprague-Dawley rats, and were repaired using either PSIS or PADM. Rats were sacrificed 1, 2, 4, 8 and 12 weeks post-repair and examined for herniation, infection, adhesions, contraction, and changes in the thickness and strength of the tissues incorporated at the defect sites. Histopathology and immunohistochemistry were performed to analyze inflammatory responses, collagen deposition and vascularization.ResultsPADM showed more dense collagen deposition and stronger mechanical properties than PSIS prior to implantation (P<0.01). However, the mechanical properties observed after integration with the surrounding native tissues was similar for PADM and PSIS. Both PADM and PSIS showed significant contraction by week 12. However, PADM tissue induced less adhesion and increased in thickness more slowly, and showed less infiltration by foreign giant cells, polymorphonuclear cells, and mononuclear cells. Improved remodeling of host tissue was observed after PSIS implantation, which was apparent from the orientation of bands of fibrous connective tissue, intermixed with newly formed blood vessels by Week 12.ConclusionPSIS showed weaker mechanical properties prior to implantation. However, after implantation PSIS induced more pronounced host responses and showed better incorporation into host tissues than PADM.

Highlights

  • More than 70 types of mesh are available, and are classified as synthetic material or biological material according their particular composition [1]

  • Improved remodeling of host tissue was observed after porcine small intestine submucosa (PSIS) implantation, which was apparent from the orientation of bands of fibrous connective tissue, intermixed with newly formed blood vessels by Week 12

  • Scanning electron microscopy (SEM) measurements showed that the collagen fibers within PSIS formed a loose meshwork (Fig. 1C), while those within porcine acellular dermal matrix (PADM) were more dense (Fig. 1D)

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Summary

Introduction

More than 70 types of mesh are available, and are classified as synthetic material or biological material according their particular composition [1]. Permanent synthetic meshes can provide enough mechanical strength for use in abdominal repairs, their non-absorbable characteristics may cause potential problems resulting in infections, adhesions, erosion into the abdominal viscera, bowel fistulae, bowel obstruction and chronic pain, which can lead to more complex and costly surgery [2]. Biological meshes are acellular materials derived from humans or animals that have an intact extracellular matrix. Biological material from humans is of limited availability and carries a high commercial cost [3]. Xenogeneic materials, such as porcine-derived tissues, do not have such problems, xenogeneic materials are considered to be clinical useful for abdominal wall repair

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