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Comparison of Cross-linked and Non-Cross-linked Acellular Porcine Dermal Scaffolds for Long-term Full-Thickness Hernia Repair in a Small Animal Model

. 2014 ; 14 () : e22. [epub] 20140617

Status PubMed-not-MEDLINE Language English Country United States Media electronic-ecollection

Document type Journal Article

BACKGROUND: This study compared the strength of incorporation and biocompatibility of 2 porcine-derived grafts (cross-linked and non-cross-linked) in a rat hernia model. METHODS: A standardized 2 × 4 cm(2) fascial defect was created in 30 Wistar rats and repaired with either a cross-linked or a non-cross-linked graft. The rats were killed 3, 6, and 12 months later. The strength of incorporation, vascularization, cellular invasion, foreign body reaction, and capsule formation were evaluated. RESULTS: Both graft materials showed cellular ingrowth and neovascularization by 3 months postimplantation. The average level of cellularization was significantly higher in the non-cross-linked grafts than in the cross-linked grafts at 6 months (2 vs 1; P = .029). Vascularization was significantly higher in the non-cross-linked grafts than in the cross-linked grafts at 6 months postimplantation (2 vs 1; P = .029) and insignificant at 3 months (2 vs 1.75; P = .311) and 12 months (1 vs 0.67; P = 1). The maximum load and breaking strength of both biomaterials increased during the study period. Overall, the strength of incorporation of the non-cross-linked grafts increased from 3 months (0.75 MPa) to 12 months (3.06 MPa) postimplantation. The strength of incorporation of the cross-linked grafts also increased from 3 months (0.59 MPa) to 12 months (1.58 MPa) postimplantation. CONCLUSIONS: The results of our study suggest that non-cross-linked grafts may be slightly more biocompatible and allow a more rapid and higher degree of cellular penetration and vascularization, resulting in stronger attachment to the tissues.

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Catena F, Ansaloni L, Gazzotti F, et al. Use of porcine dermal collagen graft (Permacol) for hernia repair in contaminated fields. Hernia. 2007;11(1):57–60. PubMed

Leber GE, Garb JL, Alexander AI, Reed WP. Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg. 1998;133(4):378–82. PubMed

Mahmoud Uslu HY, Erkek AB, Cakmak A, et al. Incisional hernia treatment with polypropylene graft: results of 10 years. Hernia. 2006;10(5):380–4. PubMed

Iannitti DA, Hope WW, Norton HJ, et al. Technique and outcomes of abdominal incisional hernia repair using a synthetic composite mesh: a report of 455 cases. J Am Coll Surg. 2008;206(1):83–8. PubMed

Voyles CR, Richardson JD, Bland KI, Tobin GR, Flint LM, Polk HCJ. Emergency abdominal wall reconstruction with polypropylene mesh: short-term benefits versus long-term complications. Ann Surg. 1981;194(2):219–23. PubMed PMC

Szczerba SR, Dumanian GA. Definitive surgical treatment of infected or exposed ventral hernia mesh. Ann Surg. 2003;237(3):437–41. PubMed PMC

Parker DM, Armstrong PJ, Frizzi JD, North JHJ. Porcine dermal collagen (Permacol) for abdominal wall reconstruction. Curr Surg. 2006;63(4):255–8. PubMed

Hiles M, Record Ritchie RD, Altizer AM. Are biologic grafts effective for hernia repair? A systematic review of the literature. Surg Innov. 2009;16(1):26–37. PubMed

Hsu PW, Salgado CJ, Kent K, et al. Evaluation of porcine dermal collagen (Permacol) used in abdominal wall reconstruction. J Plast Reconstr Aesthet Surg. 2009;62(11):1484–9. PubMed

Butler CE, Burns NK, Campbell KT, Mathur AB, Jaffari MV, Rios CN. Comparison of cross-linked and non-cross-linked porcine acellular dermal matrices for ventral hernia repair. J Am Coll Surg. 2010;211(3):368–76. PubMed

Ramirez OM. Abdominoplasty and abdominal wall rehabilitation: a comprehensive approach. Plast Reconstr Surg. 2000;105(1):425–35. PubMed

Nahabedian MY. AlloDerm performance in the setting of prosthetic breast surgery, infection, and irradiation. Plast Reconstr Surg. 2009;124(6):1743–53. PubMed

de Castro Bras LE, Proffitt JL, Bloor S, Sibbons PD. Effect of crosslinking on the performance of a collagen-derived biomaterial as an implant for soft tissue repair: a rodent model. J Biomed Mater Res B Appl Biomater. 2010;95(2):239–49. PubMed

Deeken CR, Melman L, Jenkins ED, Greco SC, Frisella MM, Matthews BD. Histologic and biomechanical evaluation of crosslinked and non-crosslinked biologic meshes in a porcine model of ventral incisional hernia repair. J Am Coll Surg. 2011;212(5):880–8. PubMed PMC

Mulier KE, Nguyen AH, Delaney JP, Marquez S. Comparison of Permacol and Strattice for the repair of abdominal wall defects. Hernia. 2011;15(3):315–9. PubMed

de Castro Bras LE, Shurey S, Sibbons PD. Evaluation of crosslinked and non-crosslinked biologic prostheses for abdominal hernia repair. Hernia. 2012;16(1):77–89. PubMed PMC

Macleod TM, Williams G, Sanders R, Green CJ. Histological evaluation of Permacol as a subcutaneous implant over a 20-week period in the rat model. Br J Plast Surg. 2005;58(4):518–32. PubMed

Ayubi FS, Armstrong PJ, Mattia MS, Parker DM. Abdominal wall hernia repair: a comparison of Permacol and Surgisis grafts in a rat hernia model. Hernia. 2008;12(4):373–8. PubMed

Oliver RF, Grant RA, Cox RW, Cooke A. Effect of aldehyde cross-linking on human dermal collagen implants in the rat. Br J Exp. Pathol. 1980;61(5):544–9. PubMed PMC

Oliver RF, Barker H, Cooke A, Stephen L. 3H-collagen turnover in non-cross-linked and aldehyde-cross-linked dermal collagen grafts. Br J Exp Pathol. 1982;63(1):13–7. PubMed PMC

Smart NJ, Marshall M, Daniels IR. Biological meshes: a review of their use in abdominal wall hernia repairs. Surgeon. 2012;10(3):159–71. PubMed

Gaertner WB, Bonsack ME, Delaney JP. Experimental evaluation of four biologic prostheses for ventral hernia repair. J Gastrointest Surg. 2007;11(10):1275–85. PubMed

O’Brien JA, Ignotz R, Montilla R, Broderick GB, Christakis A, Dunn RM. Long-term histologic and mechanical results of a Permacol abdominal wall explant. Hernia. 2011;15(2):211–5. PubMed

Wotton FT. Rejection of Permacol(R) mesh used in abdominal wall repair: a case report. World J Gastroenterol. 2009;15(34):4331–3. PubMed PMC

Petter-Puchner AH, Fortelny RH, Walder N, et al. Adverse effects associated with the use of porcine cross-linked collagen implants in an experimental model of incisional hernia repair. J Surg Res. 2008;145(1):105–10. PubMed

Blitterswijk CV. In: Tissue Engineering. van Blitterswijk C, editor. London, UK: Elsevier Academic Press; 2008.

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