Novitsky Y W, Orenstein S B, Kreutzer D L
Department of Surgery, University of Connecticut Health Center, Farmington, CT, USA,
Hernia. 2014 Oct;18(5):713-21. doi: 10.1007/s10029-013-1203-7. Epub 2013 Dec 27.
Biologic mesh (BM) prostheses are increasingly utilized for hernia repairs. Modern BMs are not only derived from different tissue sources, but also undergo various proprietary processing steps-factors that likely impact host tissue responses and mesh performance. We aimed to compare histopathologic responses to various BMs after implantation in a mouse model.
Five-mm samples of non-crosslinked [Strattice (ST)], and intentionally crosslinked [CollaMend (CM), Permacol (PC)] porcine-derived biologic meshes were implanted subcutaneously in C57BL/6 mice. 1, 4, 8, and 12 weeks post-implantation, meshes were assessed for inflammation, foreign body reaction (FBR), neocellularization, and collagen deposition using H&E and trichrome stains.
All meshes induced early polymorphonuclear cell infiltration (highest in CM; lowest in ST) that resolved by 4 weeks. ST was associated with extensive macrophage presence at 12 weeks. Foreign body response was not seen in the ST group, but was present abundantly in the CM and PC groups, highest at 8 weeks. New peripheral collagen deposition was seen only in the ST group at 12 weeks. Collagen organization was highest in the ST group as well. Both CM and PC groups were associated with fibrous encapsulation and no evidence of integration or remodeling.
Inflammation appears to be a common component of integration of all biologic meshes studied. Pronounced inflammatory responses as well as profound FBR likely lead to observed encapsulation and poor host integration of the crosslinked BMs. Overall, ST was associated with the lowest foreign body response and the highest degree of new collagen deposition and organization. These features may be key predictors for improved mesh performance during hernia repair.
生物补片（BM）假体越来越多地用于疝修补术。现代生物补片不仅来源于不同的组织，还经过各种专利加工步骤，这些因素可能会影响宿主组织反应和补片性能。我们旨在比较在小鼠模型中植入各种生物补片后的组织病理学反应。
将5毫米的非交联猪源生物补片[Strattice（ST）]以及经有意交联的猪源生物补片[CollaMend（CM）、Permacol（PC）]皮下植入C57BL/6小鼠体内。植入后1、4、8和12周，使用苏木精-伊红染色和三色染色评估补片的炎症、异物反应（FBR）、新细胞形成和胶原沉积情况。
所有补片均引起早期多形核细胞浸润（CM中最高，ST中最低），4周时消退。ST在12周时伴有大量巨噬细胞。ST组未见异物反应，但CM组和PC组有大量异物反应，8周时最高。仅ST组在12周时可见新的外周胶原沉积。ST组的胶原组织排列也最整齐。CM组和PC组均伴有纤维包裹，无整合或重塑迹象。
炎症似乎是所有研究的生物补片整合的共同组成部分。明显的炎症反应以及严重的异物反应可能导致交联生物补片出现观察到的包裹和宿主整合不良。总体而言，ST的异物反应最低，新胶原沉积和排列程度最高。这些特征可能是疝修补术中补片性能改善的关键预测指标。
