Abstract
Purpose
Post-herniation abdominal wall repair can be performed with synthetic or biologic meshes. Synthetics have been associated with complications, so biologics are promising alternatives. The methods used to decellularize biological matrices may affect the extracellular components. This study evaluated the post-implantation biological response of two allogenic acellular dermal matrices (ADMs) in a hernia model.
Methods
Testing was conducted with two ADMs from different manufacturers: RTI Biologics (ADM-R) and LifeCell (ADM-L). Samples were evaluated for collagen IV, glycosaminoglycans (GAGs), and elastin before implantation. Samples were also used to repair bilateral full-thickness defects in rat abdominal walls. Pathologist evaluations included explant dimensions, inflammation, neovascularization, mature implant tissue, fibrosis, encapsulation, necrosis, mineralization, adhesions, granulomas, and hemorrhages at four and eight weeks post-implantation.
Results
GAG distribution in ADM-R samples was more consistent with native dermis than that in ADM-L samples. Collagen IV was visible in ADM-R, but not in ADM-L. The four-week ADM-R explants showed primarily lymphocytic infiltrates, and less inflammation at eight weeks. The four-week ADM-L explants showed primarily lymphocytic infiltrates, and sustained inflammation at eight weeks. Fibroplasia at four and eight weeks was higher in ADM-L than in ADM-R. Encapsulation, mature connective tissue, and vascular profile scores were comparable between groups. Picrosirius red image analysis showed no significant differences between groups.
Conclusions
The post-processing matrix characterization and in-vivo response showed notable differences in these ADMs, despite similar allogenic origin. Future investigations into the different matrix composition with regard to fibrosis and inflammation are warranted.
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References
Franz MG (2006) The biology of hernias and the abdominal wall. Hernia 10:462–471
Bellon JM (2007) Biological reasons for an incisional hernia. In: Schumpelick V, Fitzgibbons RJ (eds) Recurrent hernia: prevention and treatment. Springer, Sturtz AG, pp 129–133
Sorensen LT, Jorgensen LN (2007) Non-surgical risk factors for recurrence of hernia. In: Schumpelick V, Fitzgibbons RJ (eds) Recurrent hernia: prevention and treatment. Springer, Sturtz AG, pp 53–58
Park A, Roth J, Kavic S (2006) Abdominal wall hernia. Curr Probl Surg 43:326–375
Bellows CF, Alder A, Helton SW (2006) Abdominal wall reconstruction using biological tissue grafts: present status and future opportunities. Expert Rev Med Devices 3(5):657–675
Diaz JJ, Guy J, Berkes MB, Guillamondegui O, Miller RS (2006) Acellular dermal allograft for ventral hernia repair in the compromised surgical field. Am Surg 72:1181–1188
Yannas IV (2004) Natural materials. In: Ratner BD, Hoffman AS, Schoen FJ, Lemons JE (eds) Biomaterials science: an introduction to materials in medicine, 2nd edn. Elsevier, San Diego, pp 127–137
Schoen FJ, Mitchell RN (2004) Tissues, the extracellular matrix and cell-biomaterial interactions. In: Ratner BD, Hoffman AS, Schoen FJ, Lemons JE (eds) Biomaterials science: an introduction to materials in medicine, 2nd edn. Elsevier, San Diego, pp 260–281
Pieper JS, van Wachem PB, van Luyn MJA, Brouwer LA, Hafmans T, Veerkamp JH, van Kuppevelt TH (2000) Attachment of glycosaminoglycans to collagenous matrices modulates the tissue response in rats. Biomaterials 21:1689–1699
Sarr MG, Podgaetz E, Lane JS (2007) Bioprosthesis: are they the future of incisional/acquired hernia repair. In: Schumpelick V, Fitzgibbons RJ (eds) Recurrent hernia: prevention and treatment. Springer, Sturtz AG, pp 152–156
Badylak SF, Gilbert TW (2008) Immune response to biologic scaffold materials. Semin Immunol 20:109–116
Hoerstup SP, Vacanti JP (2004) Overview of tissue engineering. In: Ratner BD, Hoffman AS, Schoen FJ, Lemons JE (eds) Biomaterials science: an introduction to materials in medicine, 2nd edn. Elsevier, San Diego, pp 712–728
Anderson JM (2004) Inflammation, wound healing, and the foreign-body response. In: Ratner BD, Hoffman AS, Schoen FJ, Lemons JE (eds) Biomaterials science: an introduction to materials in medicine, 2nd edn. Elsevier, San Diego, pp 296–304
Macleod TM, Williams G, Sanders R, Green CJ (2005) Histological evaluation of Permacol as a subcutaneous implant over a 20-week period in the rat model. Br J Plast Surg 58:518–532
Kayaoglu HA, Ozkan N, Hazinedaroglu SM, Ersoy OF, Koseoglu RD (2005) An assessment of the effects of two types of bioresorbable barriers to prevent intra-abdominal adhesions in rats. Surg Today 35:946–950
Kaleya RN (2005) Evaluation of implant/host tissue interactions following intraperitoneal implanation of porcine dermal collagen prosthesis in the rat. Hernia 9:269–276
Petter-Puchner AH, Fortelny RH, Walder N, Mittermayr R, Ohlinger W, van Grievsven M, Redl H (2008) Adverse effects associated with the use of porcine cross-linked collagen implants in an experimental model of incisional hernia repair. J Surg Res 145:105–110
Ayubi FS, Armstrong PJ, Mattia MS, Parker DM (2008) Abdominal wall hernia repair: a comparison of Permacol and Surgisis grafts in a rat hernia model. Hernia 12:373–378
Junqueria LC, Canerio J (2005) Basic histology: text and atlas, 11th edn. McGraw–Hill, New York, pp 4–5 111–112
Cuttle L, Nataatmadja M, Fraser JF, Kempf M, Kimble RM, Hayes MT (2005) Collagen in the scarless fetal wound: detection with picrosirius-polarization. Wound Repair Regen 13:198–204
Dayan D, Hiss Y, Hirshberg A, Bubis JJ, Wolman M (1989) Are the polarization colors of picrosirius red-stained collagen determined only by the diameter of the fibers? Histochemistry 93(1):27–29
Sievert KD, Fandel T, Wefer J, Gleason CA, Nunes L, Dahiya R, Tanagho EA (2006) Collagen I:III ratio in canine heterologous bladder acellular matrix grafts. World J Urol 24:101–109
Hodde J (2002) Naturally occurring scaffolds for soft tissue repair and regeneration. Tissue Eng 8(2):295–308
Cook JL, Fox DB, Kuroki K, Jayo M, De Deyne PG (2008) In vitro and in vivo comparison of five biomaterials used for orthopedic soft tissue augmentation. Am J Vet Res 69:148–156
Cotran RS, Kumar V, Collins T (1999) Pathologic basis of disease, 6th edn. W.B. Saunders, New York, pp 50–88 89–111
Bernabei P, Rigamonti L, Ariotti S, Stella M, Castagnoli C, Novelli F (1999) Functional analysis of T lymphocytes infiltrating the dermis and epidermis of post-burn hypertrophic scar tissues. Burns 25:43–48
Acknowledgments
The authors would like to thank the donors and their families for their selfless gift of tissue donation, without which this research would not have been possible. The authors would like to thank RTI Biologics, Inc. for their continued support of this research.
Conflict of interest
The execution and evaluation of the in-vivo portion of this study was conducted by an independent laboratory (WuXi Apptec, St. Paul, MN, USA). All samples were evaluated with a blinded evaluation. All authors were employees of RTI Biologics at the time of evaluation of the study results. Review and statistical analysis of this study report, provided by WuXi Apptec, was conducted with a blinded evaluation of biological performance.
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Faleris, J.A., Hernandez, R.M.C., Wetzel, D. et al. In-vivo and in-vitro histological evaluation of two commercially available acellular dermal matrices. Hernia 15, 147–156 (2011). https://doi.org/10.1007/s10029-010-0749-x
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DOI: https://doi.org/10.1007/s10029-010-0749-x