Department of Surgery, Division of Acute Care Surgery, University of Michigan Medical Center, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.
Hernia. 2012 Dec;16(6):677-87. doi: 10.1007/s10029-012-0941-2. Epub 2012 Jun 28.
To demonstrate improved healing of a midline laparotomy after application of mesenchymal stromal cells and platelet-rich plasma on a collagen matrix and introduce a potential cellular-based therapy for the prevention of incisional hernia formation.
Up to 10 % of laparotomies are complicated by postoperative incisional hernias. Despite continuous improvements in surgical technique and technology, hernia rates have remained constant. Cell-based therapies focused on augmentation of the body's natural healing properties could reduce hernia formation.
Midline laparotomies were performed on 42 Lewis rats. Three groups were studied: (1) primary repair only, (2) primary repair with CollaTape™ (CoTa) overlay and platelet-rich plasma (PRP), and (3) primary repair with CoTa overlay and PRP and bone marrow-derived mesenchymal stromal cells (BM-MSCs). Abdominal wall fascia was recovered at 4 and 8 weeks in each group. Biomechanical testing and histological evaluation was performed.
At 4 weeks, there was a twofold increase in tensile strength between groups 1 and 2 and a fourfold increase between groups 1 and 3 (p < 0.001). Group 3 had a 320 % increase in total energy absorption at 4 weeks compared to group 1 and a 142 % increase at 8 weeks (p < 0.001). Vascularization and collagen abundance were significantly increased in group 3 at both time points.
The addition of BM-MSCs, PRP, and CoTa led to a marked improvement in abdominal wall strength and energy absorption. Histologic evaluation confirmed increased vascularity and collagen abundance consistent with the biomechanical findings. Application of this therapy may ultimately reduce incisional hernia formation.
展示应用间充质基质细胞和富含血小板的血浆在胶原基质上对中线切口愈合的改善，并介绍一种潜在的细胞基础疗法，以预防切口疝的形成。
多达 10%的剖腹手术会出现术后切口疝并发症。尽管手术技术和技术不断改进，但疝的发生率仍然保持不变。以增强机体自然愈合特性为重点的细胞疗法可能会减少疝的形成。
对 42 只 Lewis 大鼠进行中线剖腹手术。研究了三组：（1）仅行初次修复，（2）初次修复加 CollaTape™（CoTa）覆盖加富含血小板的血浆（PRP），（3）初次修复加 CoTa 覆盖加 PRP 和骨髓间充质基质细胞（BM-MSCs）。每组在第 4 和第 8 周时回收腹壁筋膜。进行生物力学测试和组织学评估。
在第 4 周时，组 1 和组 2 之间的拉伸强度增加了两倍，组 1 和组 3 之间增加了四倍（p<0.001）。与组 1 相比，组 3 在第 4 周时总能量吸收增加了 320%，第 8 周时增加了 142%（p<0.001）。在两组时间点，组 3 的血管生成和胶原蛋白丰度均显著增加。
添加 BM-MSCs、PRP 和 CoTa 可显著提高腹壁强度和能量吸收。组织学评估证实，血管生成和胶原蛋白丰度增加，与生物力学发现一致。应用这种治疗方法可能最终减少切口疝的形成。
