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Modification of collagen formation using supplemented mesh materials

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Abstract

Background

Formation of recurrent inguinal and incisional hernia shows an underlying defect in the wound healing process. Even following mesh repair an altered collagen formation and insufficient mesh integration has been found as main reason for recurrences. Therefore the development of bioactive mesh materials to achieve a local modification of the scar formation to improve patients outcome is advisable.

Methods

Thirty-six male Wistar rats were used within this study. A Mersilene ® mesh sample was implanted after midline skin incision and subcutaneous preparation. Before implantation mesh samples were incubated for 30 minutes with either one of the following agents: doxycycline, TGF-beta 3, zinc-hydrogeneaspartate, ascorbic acid, hyaluronic acid. Incubation with a physiologic 0.9 % NaCl solution served as control. Seven and 90 days after mesh implantation 3 animals from each group (n = 6) were sacrificed for morphological observations. Collagen quantity and quality was analyzed measuring the collagen/protein as well as the collagen type I/III ratio.

Results

Following an implantation interval of 90 days supplementation with doxycycline (39.3 ± 7.0 µg/mg) and hyaluronic acid (34.4 ± 5.8 µg/mg) were found to have a significantly increased collagen/protein ratio compared to implantation of the pure Mersilene ® mesh samples (28.3 ± 1.9 µg/mg). Furthermore, an overall increase of the collagen type I/III ratio was found in all groups indicating scar maturation over time. However, no significant differences were found after 7 and 90 days of implantation comparing collagen type I/III ratio of supplemented mesh samples and control group.

Conclusions

In summary, we found an influence of supplemented mesh materials on collagen deposition. However, the investigated bioactive agents with reported influence on wound healing were not associated with an improved quality in scar formation.

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References

  1. Agren MS (1990) Studies on zinc in wound healing. Acta Derm Venereol Suppl (Stockh) 154:1–36

    CAS  Google Scholar 

  2. Bellon JM, Bajo A, Ga-Honduvilla N, Gimeno MJ, Pascual G, Guerrero A et al (2001) Fibroblasts from the transversalis fascia of young patients with direct inguinal hernias show constitutive MMP-2 overexpression. Ann Surg 233(2):287–291

    Article  PubMed  CAS  Google Scholar 

  3. Bellon JM, Bujan J, Honduvilla NG, Jurado F, Gimeno MJ, Turnay J et al (1997) Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes. Eur J Clin Invest 27(6):510–516

    Article  PubMed  CAS  Google Scholar 

  4. Birk DE, Mayne R (1997) Localization of collagen types I, III and V during tendon development. Changes in collagen types I and III are correlated with changes in fibril diameter. Eur J Cell Biol 72(4):352–361

    PubMed  CAS  Google Scholar 

  5. Dubay DA, Wang X, Kuhn MA, Robson MC, Franz MG (2004) The prevention of incisional hernia formation using a delayed-release polymer of basic fibroblast growth factor. Ann Surg 240(1):179–186

    Article  PubMed  Google Scholar 

  6. Dubay DA, Wang X, Kuhn MA, Robson MC, Franz MG (2004) The prevention of incisional hernia formation using a delayed-release polymer of basic fibroblast growth factor. Ann Surg 240(1):179–186

    Article  PubMed  Google Scholar 

  7. Farris PK (2005) Topical vitamin C: a useful agent for treating photoaging and other dermatologic conditions. Dermatol Surg 31(7 Pt 2):814–817

    PubMed  CAS  Google Scholar 

  8. Friedman DW, Boyd CD, Mackenzie JW, Norton P, Olson RM, Deak SB (1993) Regulation of collagen gene expression in keloids and hypertrophic scars. J Surg Res 55(2):214–222

    Article  PubMed  CAS  Google Scholar 

  9. Friedman DW, Boyd CD, Norton P, Greco RS, Boyarsky AH, Mackenzie JW et al (1993) Increases in type III collagen gene expression and protein synthesis in patients with inguinal hernias (see comments). Ann Surg 218(6):754–760

    Article  PubMed  CAS  Google Scholar 

  10. Guo Y, Xie C, Rodriguez RM, Light RW (2005) Factors related to recurrence of spontaneous pneumothorax. Respirology 10(3):378–384

    Article  PubMed  Google Scholar 

  11. Henkel W, Glanville RW (1982) Covalent crosslinking between molecules of type I and type III collagen. The involvement of the N-terminal, nonhelical regions of the alpha 1 (I) and alpha 1 (III) chains in the formation of intermolecular crosslinks. Eur J Biochem 122(1):205–213

    Article  PubMed  CAS  Google Scholar 

  12. Jansen PL, Mertens PP, Klinge U, Schumpelick V (2004) The biology of hernia formation. Surgery 136(1):1–4

    Article  PubMed  Google Scholar 

  13. Junge K, Klinge U, Rosch R, Mertens PR, Kirch J, Klosterhalfen B et al (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389(1):17–22

    Article  PubMed  Google Scholar 

  14. Junqueira LC, Cossermelli W, Brentani R (1978) Differential staining of collagens type I, II and III by Sirius Red and polarization microscopy. Arch Histol Jpn 41(3):267–274

    PubMed  CAS  Google Scholar 

  15. Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B (2000) Abnormal collagen I to III distribution in the skin of patients with incisional hernia. Eur Surg Res 32(1):43–48

    Article  PubMed  CAS  Google Scholar 

  16. Klinge U, Zheng H, Si Z, Schumpelick V, Bhardwaj RS, Muys L et al (1999) Expression of the extracellular matrix proteins collagen I, collagen III and fibronectin and matrix metalloproteinase-1 and -13 in the skin of patients with inguinal hernia. Eur Surg Res 31(6):480–490

    Article  PubMed  CAS  Google Scholar 

  17. Korenkov M, Yuecel N, Koebke J, Schierholz J, Morsczeck C, Tasci I et al (2005) Local administration of TGF-beta1 to reinforce the anterior abdominal wall in a rat model of incisional hernia. Hernia 9(3):252–258

    Article  PubMed  CAS  Google Scholar 

  18. Krasner RI, Young G (1958) Role of hyaluronidase and the hyaluronic acid capsule in the survival and dissemination of group A streptococci in the hamster cheek pouch. J Bacteriol 76(4):349–354

    PubMed  CAS  Google Scholar 

  19. Lamparter S, Slight SH, Weber KT (2002) Doxycycline and tissue repair in rats. J Lab Clin Med 139(5):295–302

    Article  PubMed  CAS  Google Scholar 

  20. Lauhio A, Konttinen YT, Tschesche H, Nordstrom D, Salo T, Lahdevirta J et al (1994) Reduction of matrix metalloproteinase 8-neutrophil collagenase levels during long-term doxycycline treatment of reactive arthritis. Antimicrob Agents Chemother 38(2):400–402

    PubMed  CAS  Google Scholar 

  21. Lee KS, Jin SM, Kim SS, Lee YC (2004) Doxycycline reduces airway inflammation and hyperresponsiveness in a murine model of toluene diisocyanate-induced asthma. J Allergy Clin Immunol 113(5):902–909

    Article  PubMed  CAS  Google Scholar 

  22. Lopez-De Leon A, Rojkind M (1985) A simple micromethod for collagen and total protein determination in formalin-fixed paraffin-embedded sections. J Histochem Cytochem 33(8):737–743

    PubMed  CAS  Google Scholar 

  23. Madden JW, Peacock EE Jr (1968) Studies on the biology of collagen during wound healing. I. Rate of collagen synthesis and deposition in cutaneous wounds of the rat. Surgery 64(1):288–294

    PubMed  CAS  Google Scholar 

  24. Mast BA, Flood LC, Haynes JH, DePalma RL, Cohen IK, Diegelmann RF et al (1991) Hyaluronic acid is a major component of the matrix of fetal rabbit skin and wounds: implications for healing by regeneration. Matrix 11(1):63–68

    PubMed  CAS  Google Scholar 

  25. Mast BA, Haynes JH, Krummel TM, Diegelmann RF, Cohen IK (1992) In vivo degradation of fetal wound hyaluronic acid results in increased fibroplasia, collagen deposition and neovascularisation. Plast Reconstr Surg 89(3):503–509

    Article  PubMed  CAS  Google Scholar 

  26. Moore AR (2000) Hyaluronan—a review of the recent patent literature. IDrugs 3(2):198–201

    PubMed  CAS  Google Scholar 

  27. Mustoe TA, Pierce GF, Thomason A, Gramates P, Sporn MB, Deuel TF (1987) Accelerated healing of incisional wounds in rats induced by transforming growth factor-beta. Science 237(4820):1333–1336

    Article  PubMed  CAS  Google Scholar 

  28. Niethard FU (1999) Pathogenesis of osteoarthritis—approaches to specific therapy. Am J Orthop 28(11 Suppl):8–10

    PubMed  CAS  Google Scholar 

  29. Norman JN, Rahmat A, Smith G (1975) Effect of supplements of zinc salts on the healing of incised wounds in the rat and guinea pig. J Nutr 105(7):822–826

    PubMed  CAS  Google Scholar 

  30. O’Meara SM, Cullum NA, Majid M, Sheldon TA (2001) Systematic review of antimicrobial agents used for chronic wounds. Br J Surg 88(1):4–21

    Article  PubMed  CAS  Google Scholar 

  31. Pans A, Albert A, Lapiere CM, Nusgens B (2001) Biochemical study of collagen in adult groin hernias. J Surg Res 95(2):107–113

    Article  PubMed  CAS  Google Scholar 

  32. Ren GY, Dong FS, Wang J, Shi PK (2004) The effect of hyaluronic acid external film on rats wound healing. Zhonghua Zheng Xing Wai Ke Za Zhi 20(5):380–383

    PubMed  Google Scholar 

  33. Robson MC, Dubay DA, Wang X, Franz MG (2004) Effect of cytokine growth factors on the prevention of acute wound failure. Wound Repair Regen 12(1):38–43

    Article  PubMed  Google Scholar 

  34. Robson MC, Dubay DA, Wang X, Franz MG (2004) Effect of cytokine growth factors on the prevention of acute wound failure. Wound Repair Regen 12(1):38–43

    Article  PubMed  Google Scholar 

  35. Schumpelick V, Conze J, Klinge U (1996) Preperitoneal mesh-plasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias. Chirurg 67(10):1028–1035

    Article  PubMed  CAS  Google Scholar 

  36. Suomalainen K, Sorsa T, Ingman T, Lindy O, Golub LM (1992) Tetracycline inhibition identifies the cellular origin of interstitial collagenases in human periodontal diseases in vivo. Oral Microbiol Immunol 7(2):121–123

    PubMed  CAS  Google Scholar 

  37. Vaxman F, Chalkiadakis G, Olender S, Maldonado H, Aprahamian M, Bruch JF et al (1990) Improvement in the healing of colonic anastomoses by vitamin B5 and C supplements Experimental study in the rabbit. Ann Chir 44(7):512–520

    PubMed  CAS  Google Scholar 

  38. Vazquez JR, Short B, Findlow AH, Nixon BP, Boulton AJ, Armstrong DG (2003) Outcomes of hyaluronan therapy in diabetic foot wounds. Diabetes Res Clin Pract 59(2):123–127

    Article  PubMed  CAS  Google Scholar 

  39. Zhang JY, Doll BA, Beckman EJ, Hollinger JO (2003) Three-dimensional biocompatible ascorbic acid-containing scaffold for bone tissue engineering. Tissue Eng 9(6):1143–1157

    Article  PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany

    K. Junge, R. Rosch, U. Klinge & V. Schumpelick

  2. IZKF BIOMAT, Technical University of Aachen, Aachen, Germany

    U. Klinge

  3. German Centre of Excellence for Biomaterial and Implant Pathology, Technical University of Aachen, Aachen, Germany

    K. Junge, R. Rosch & U. Klinge

  4. Joint Institute for Surgical Research, Technical University of Aachen, Aachen, Germany

    K. Junge, R. Rosch, M. Anurov, S. Titkova, A. Öttinger, U. Klinge & V. Schumpelick

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  1. K. Junge
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  2. R. Rosch
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  3. M. Anurov
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  4. S. Titkova
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  6. U. Klinge
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  7. V. Schumpelick
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Correspondence to K. Junge.

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Junge, K., Rosch, R., Anurov, M. et al. Modification of collagen formation using supplemented mesh materials. Hernia 10, 492–497 (2006). https://doi.org/10.1007/s10029-006-0148-5

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