Leberfinger Ashley N, Hospodiuk Monika, Pena-Francesch Abdon, Ayan Bugra, Ozbolat Veli, Koduru Srinivas V, Ozbolat Ibrahim T, Demirel Melik C, Ravnic Dino J
Department of Surgery, Penn State University College of Medicine, Hershey, Pa.
Department of Engineering Science and Mechanics, Penn State University, University Park, Pa.
Plast Reconstr Surg Glob Open. 2018 Aug 7;6(8):e1881. doi: 10.1097/GOX.0000000000001881. eCollection 2018 Aug.
Hernia repair is a common surgical procedure with polypropylene (PP) mesh being the standard material for correction because of its durability. However, complications such as seroma and pain are common, and repair failures still approach 15% secondary to poor tissue integration. In an effort to enhance mesh integration, we evaluated the applicability of a squid ring teeth (SRT) protein coating for soft-tissue repair in an abdominal wall defect model. SRT is a biologically derived high-strength protein with strong mechanical properties. We assessed tissue integration, strength, and biocompatibility of a SRT-coated PP mesh in a first-time pilot animal study.
PP mesh was coated with SRT (SRT-PP) and tested for mechanical strength against uncoated PP mesh. Cell proliferation and adhesion studies were performed in vitro using a 3T3 cell line. Rats underwent either PP (n = 3) or SRT-PP (n = 6) bridge mesh implantation in an anterior abdominal wall defect model. Repair was assessed clinically and radiographically, with integration evaluated by histology and mechanical testing at 60 days.
Cell proliferation was enhanced on SRT-PP mesh. This was corroborated in vivo by abdominal wall histology, dramatically diminished craniocaudal mesh contraction, improved strength testing, and higher tissue failure strain. There was no increase in seroma or visceral adhesion formation. No foreign body reactions were noted on liver histology.
SRT applied as a coating appears to augment mesh-tissue integration and improve abdominal wall stability following bridged repair. Further studies in larger animals will determine its applicability for hernia repair in patients.
疝修补术是一种常见的外科手术，聚丙烯（PP）网片因其耐用性而成为修复的标准材料。然而，血清肿和疼痛等并发症很常见，由于组织整合不良，修复失败率仍接近15%。为了增强网片整合，我们在腹壁缺损模型中评估了鱿鱼环齿（SRT）蛋白涂层在软组织修复中的适用性。SRT是一种生物衍生的高强度蛋白，具有强大的机械性能。在首次试点动物研究中，我们评估了SRT涂层PP网片的组织整合、强度和生物相容性。
PP网片用SRT涂层（SRT-PP），并与未涂层的PP网片进行机械强度测试。使用3T3细胞系进行体外细胞增殖和粘附研究。在大鼠前腹壁缺损模型中植入PP（n = 3）或SRT-PP（n = 6）桥接网片。在临床上和影像学上评估修复情况，在60天时通过组织学和机械测试评估整合情况。
SRT-PP网片上的细胞增殖增强。腹壁组织学在体内证实了这一点，颅尾向网片收缩显著减少，强度测试改善，组织破坏应变更高。血清肿或内脏粘连形成没有增加。肝脏组织学未发现异物反应。
作为涂层应用的SRT似乎增强了网片与组织的整合，并改善了桥接修复后腹壁的稳定性。在更大动物中的进一步研究将确定其在患者疝修补中的适用性。
