• MeSH
• incizní kýla * chirurgie   MeSH
• kolektomie MeSH
• lidé MeSH
• ventrální hernie * chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Incisional hernia is the most common complication following abdominal surgery. While mesh repair is common, none of the current meshes mimic the physiology of the abdominal wall. This study compares suture only repair with polypropylene mesh and a prototype of a novel implant (poly-epsilon-caprolactone nanofibers) and their influence on the physiology of an abdominal wall in an animal model. METHODS: 27 Chinchilla rabbits were divided into six groups based on the type of the implant. Midline abdominal incision was repaired using one of the compared materials with suture alone serving as the control. 6 weeks post-surgery animals were killed and their explanted abdominal wall subjected to biomechanical testing. RESULTS: Both-hysteresis and maximum strength curves showed high elasticity and strength in groups where the novel implant was used. Polypropylene mesh proved as stiff and fragile compared to other groups. CONCLUSION: Poly-epsilon-caprolactone nanofiber scaffold is able to improve the dynamic properties of healing fascia with no loss of maximum tensile strength when compared to polypropylene mesh in an animal model.

• Klíčová slova
• Dynamic properties, Hernia, Nanofibres, PCL,
• MeSH
• abdominální hernie * etiologie   chirurgie   MeSH
• abdominoplastika přístrojové vybavení   metody   MeSH
• chirurgické síťky * MeSH
• incizní kýla * etiologie   chirurgie   MeSH
• králíci MeSH
• modely nemocí na zvířatech MeSH
• nanovlákna terapeutické užití   MeSH
• operace kýly přístrojové vybavení   metody   MeSH
• pevnost v tahu MeSH
• polypropyleny terapeutické užití   MeSH
• pružnost MeSH
• testování materiálů MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• polypropyleny MeSH

Although mesh use has significantly improved the outcomes of hernia and pelvic organ prolapse repair, long-term recurrence rates remain unacceptably high. We aim to determine the in vivo degradation and functional outcome of reconstructed abdominal wall defects, using slowly degradable electrospun ureidopyrimidinone moieties incorporated into a polycarbonate backbone (UPy-PC) implant compared to an ultra-lightweight polypropylene (PP) textile mesh with high pore stability. Twenty four New-Zealand rabbits were implanted with UPy-PC or PP to either reinforce a primary fascial defect repair or to cover (referred to as gap bridging) a full-thickness abdominal wall defect. Explants were harvested at 30, 90 and 180 days. The primary outcome measure was uniaxial tensiometry. Secondary outcomes were the recurrence of herniation, morphometry for musculofascial tissue characteristics, inflammatory response and neovascularization. PP explants compromised physiological abdominal wall compliance from 90 days onwards and UPy-PC from 180 days. UPy-PC meshes induced a more vigorous inflammatory response than PP at all time points. We observed progressively more signs of muscle atrophy and intramuscular fatty infiltration in the entire explant area for both mesh types. UPy-PC implants are replaced by a connective tissue stiff enough to prevent abdominal wall herniation in two-thirds of the gap-bridged full-thickness abdominal wall defects. However, in one-third there was sub-clinical herniation. The novel electrospun material did slightly better than the textile PP yet outcomes were still suboptimal. Further research should investigate what drives muscular atrophy, and whether novel polymers would eventually generate a physiological neotissue and can prevent failure and/or avoid collateral damage.

• Publikační typ
• časopisecké články MeSH

PURPOSE: Incisional hernia repair is an unsuccessful field of surgery, with long-term recurrence rates reaching up to 50% regardless of technique or mesh material used. Various implants and their positioning within the abdominal wall pose numerous long-term complications that are difficult to treat due to their permanent nature and the chronic foreign body reaction they trigger. Materials mimicking the 3D structure of the extracellular matrix promote cell adhesion, proliferation, migration, and differentiation. Some electrospun nanofibrous scaffolds provide a topography of a natural extracellular matrix and are cost effective to manufacture. MATERIALS AND METHODS: A composite scaffold that was assembled out of a standard polypropylene hernia mesh and poly-ε-caprolactone (PCL) nanofibers was tested in a large animal model (minipig), and the final scar tissue was subjected to histological and biomechanical testing to verify our in vitro results published previously. RESULTS: We have demonstrated that a layer of PCL nanofibers leads to tissue overgrowth and the formation of a thick fibrous plate around the implant. Collagen maturation is accelerated, and the final scar is more flexible and elastic than under a standard polypropylene mesh with less pronounced shrinkage observed. However, the samples with the composite scaffold were less resistant to distracting forces than when a standard mesh was used. We believe that the adverse effects could be caused due to the material assembly, as they do not comply with our previous results. CONCLUSION: We believe that PCL nanofibers on their own can cause enough fibroplasia to be used as a separate material without the polypropylene base, thus avoiding potential adverse effects caused by any added substances.

• Klíčová slova
• PCL, biomechanical, hernia, large animal, mesh, minipig, nanofibers,
• MeSH
• břišní stěna chirurgie   MeSH
• chirurgické síťky * MeSH
• hernie * MeSH
• kolagen metabolismus   MeSH
• miniaturní prasata MeSH
• modely nemocí na zvířatech MeSH
• myši MeSH
• nanovlákna chemie   MeSH
• operace kýly přístrojové vybavení   metody   MeSH
• polyestery MeSH
• polypropyleny chemie   MeSH
• prasata MeSH
• testování materiálů MeSH
• tkáňové podpůrné struktury chemie   MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kolagen MeSH
• polycaprolactone MeSH Prohlížeč
• polyestery MeSH
• polypropyleny MeSH

Incisional hernia is the most common postoperative complication, affecting up to 20% of patients after abdominal surgery. Insertion of a synthetic surgical mesh has become the standard of care in ventral hernia repair. However, the implementation of a mesh does not reduce the risk of recurrence and the onset of hernia recurrence is only delayed by 2-3 years. Nowadays, more than 100 surgical meshes are available on the market, with polypropylene the most widely used for ventral hernia repair. Nonetheless, the ideal mesh does not exist yet; it still needs to be developed. Polycaprolactone nanofibers appear to be a suitable material for different kinds of cells, including fibroblasts, chondrocytes, and mesenchymal stem cells. The aim of the study reported here was to develop a functionalized scaffold for ventral hernia regeneration. We prepared a novel composite scaffold based on a polypropylene surgical mesh functionalized with poly-ε-caprolactone (PCL) nanofibers and adhered thrombocytes as a natural source of growth factors. In extensive in vitro tests, we proved the biocompatibility of PCL nanofibers with adhered thrombocytes deposited on a polypropylene mesh. Compared with polypropylene mesh alone, this composite scaffold provided better adhesion, growth, metabolic activity, proliferation, and viability of mouse fibroblasts in all tests and was even better than a polypropylene mesh functionalized with PCL nanofibers. The gradual release of growth factors from biocompatible nanofiber-modified scaffolds seems to be a promising approach in tissue engineering and regenerative medicine.

• Klíčová slova
• growth factors, hernia regeneration, in vitro, nanofibers, polypropylene mesh,
• MeSH
• biokompatibilní materiály * chemie   toxicita   MeSH
• chirurgické síťky * MeSH
• incizní kýla chirurgie   MeSH
• myši MeSH
• nanovlákna * chemie   toxicita   MeSH
• polyestery * chemie   toxicita   MeSH
• polypropyleny * chemie   toxicita   MeSH
• proliferace buněk účinky léků   MeSH
• trombocyty cytologie   MeSH
• viabilita buněk účinky léků   MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biokompatibilní materiály * MeSH
• polycaprolactone MeSH Prohlížeč
• polyestery * MeSH
• polypropyleny * MeSH

Incisional hernia affects up to 20% of patients after abdominal surgery. Unlike other types of hernia, its prognosis is poor, and patients suffer from recurrence within 10 years of the operation. Currently used hernia-repair meshes do not guarantee success, but only extend the recurrence-free period by about 5 years. Most of them are nonresorbable, and these implants can lead to many complications that are in some cases life-threatening. Electrospun nanofibers of various polymers have been used as tissue scaffolds and have been explored extensively in the last decade, due to their low cost and good biocompatibility. Their architecture mimics the natural extracellular matrix. We tested a biodegradable polyester poly-ε-caprolactone in the form of nanofibers as a scaffold for fascia healing in an abdominal closure-reinforcement model for prevention of incisional hernia formation. Both in vitro tests and an experiment on a rabbit model showed promising results.

• Klíčová slova
• growth factors, hernia regeneration, in vivo, nanofibers, surgical mesh,
• MeSH
• biomechanika MeSH
• břicho chirurgie   MeSH
• buňky 3T3 MeSH
• chirurgické síťky MeSH
• hernie prevence a kontrola   MeSH
• histocytochemie MeSH
• hojení ran účinky léků   MeSH
• králíci MeSH
• mezibuněčné signální peptidy a proteiny chemie   farmakologie   terapeutické užití   MeSH
• myši MeSH
• nanovlákna chemie   terapeutické užití   MeSH
• polyestery chemie   terapeutické užití   MeSH
• polypropyleny chemie   terapeutické užití   MeSH
• pooperační komplikace prevence a kontrola   MeSH
• řízená tkáňová regenerace MeSH
• techniky uzavření břišních poranění přístrojové vybavení   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• mezibuněčné signální peptidy a proteiny MeSH
• polycaprolactone MeSH Prohlížeč
• polyestery MeSH
• polypropyleny MeSH