B East1, J Woleský2, R Divín3,4, M Otáhal5,6, K Vocetková4,7, V Sovková4,7, V H Blahnová3,4,7, M Koblížek8, P Kubový6, A Nečasová9, A Staffa10, A Ch de Beaux11, J Lorenzová9, E Amler3,4. 1. 3rd Department of Surgery, 1st Faculty of Medicine, Motol University Hospital, V uvalu 84, 150 06, Prague, Czech Republic. Barbora.east@gmail.com. 2. 3rd Department of Surgery, 1st Faculty of Medicine, Motol University Hospital, V uvalu 84, 150 06, Prague, Czech Republic. 3. Department of Biophysics, 2nd Faculty of Medicine, Charles University, V uvalu 84, 150 06, Prague, Czech Republic. 4. University Centre for Energy Efficient Buildings, Czech Technical University in Prague, Trinecka 1024, 273 43, Buštěhrad, Czech Republic. 5. Department of Natural Sciences, Faculty of Biomedical Engineering, Czech Technical University in Prague, Sitna 3105, 272 01, Kladno, Czech Republic. 6. Department of Anatomy and Biomechanics, Faculty of Physical Education and Sport, Charles University in Prague, Jose Martího 31, 162 52, Prague 6, Czech Republic. 7. Institute of Experimental Medicine of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague, Czech Republic. 8. Department of Pathology, 2nd Faculty of Medicine, Motol University Hospital, Charles University, V uvalu, 15006, Prague, Czech Republic. 9. Department of Surgery & Orthopaedics, Faculty of Veterinary Medicine, Small Animal Clinic, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic. 10. Large Animal Clinical Laboratory, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic. 11. Royal Infirmary, Department of General Surgery, 51 Little France Crescent, Old Dalkeith Rd, Edinburgh, EH16 4SA, UK.
Abstract
BACKGROUND: Surgical mesh is widely used not only to treat but also to prevent incisional hernia formation. Despite much effort by material engineers, the 'ideal' mesh mechanically, biologically and surgically easy to use remains elusive. Advances in tissue engineering and nanomedicine have allowed new concepts to be tested with promising results in both small and large animals. Abandoning the concept of a pre-formed mesh completely for a 'pour in liquid mesh' has never been tested before. MATERIALS AND METHODS: Thirty rabbits underwent midline laparotomy with closure using an absorbable suture and small stitch small bites technique. In addition, their abdominal wall closure was reinforced by a liquid nanofibrous scaffold composed of a fibrin sealant and nanofibres of poly-ε-caprolactone with or without hyaluronic acid or the sealant alone, poured in as an 'onlay' over the closed abdominal wall. The animals were killed at 6 weeks and their abdominal wall was subjected to histological and biomechanical evaluations. RESULTS: All the animals survived the study period with no major complication. Histological evaluation showed an eosinophilic infiltration in all groups and foreign body reaction more pronounced in the groups with nanofibres. Biomechanical testing demonstrated that groups treated with nanofibres developed a scar with higher tensile yield strength. CONCLUSION: The use of nanofibres in a liquid form applied to the closed abdominal wall is easy to use and improves the biomechanical properties of healing fascia at 6 weeks after midline laparotomy in a rabbit model.
BACKGROUND: Surgical mesh is widely used not only to treat but also to prevent incisional hernia formation. Despite much effort by material engineers, the 'ideal' mesh mechanically, biologically and surgically easy to use remains elusive. Advances in tissue engineering and nanomedicine have allowed new concepts to be tested with promising results in both small and large animals. Abandoning the concept of a pre-formed mesh completely for a 'pour in liquid mesh' has never been tested before. MATERIALS AND METHODS: Thirty rabbits underwent midline laparotomy with closure using an absorbable suture and small stitch small bites technique. In addition, their abdominal wall closure was reinforced by a liquid nanofibrous scaffold composed of a fibrin sealant and nanofibres of poly-ε-caprolactone with or without hyaluronic acid or the sealant alone, poured in as an 'onlay' over the closed abdominal wall. The animals were killed at 6 weeks and their abdominal wall was subjected to histological and biomechanical evaluations. RESULTS: All the animals survived the study period with no major complication. Histological evaluation showed an eosinophilic infiltration in all groups and foreign body reaction more pronounced in the groups with nanofibres. Biomechanical testing demonstrated that groups treated with nanofibres developed a scar with higher tensile yield strength. CONCLUSION: The use of nanofibres in a liquid form applied to the closed abdominal wall is easy to use and improves the biomechanical properties of healing fascia at 6 weeks after midline laparotomy in a rabbit model.
Authors: C Fink; P Baumann; M N Wente; P Knebel; T Bruckner; A Ulrich; J Werner; M W Büchler; M K Diener Journal: Br J Surg Date: 2013-11-26 Impact factor: 6.939
Authors: C San Miguel; D Melero; E Jiménez; P López; Á Robin; L A Blázquez; J López-Monclús; E González; C Jiménez; M Á García-Ureña Journal: Hernia Date: 2018-10-04 Impact factor: 4.739
Authors: An P Jairam; Lucas Timmermans; Hasan H Eker; Robert E G J M Pierik; David van Klaveren; Ewout W Steyerberg; Reinier Timman; Arie C van der Ham; Imro Dawson; Jan A Charbon; Christoph Schuhmacher; André Mihaljevic; Jakob R Izbicki; Panagiotis Fikatas; Philip Knebel; René H Fortelny; Gert-Jan Kleinrensink; Johan F Lange; Hans J Jeekel Journal: Lancet Date: 2017-06-20 Impact factor: 79.321
Authors: Mackenzie E Coden; Lucas F Loffredo; Matthew T Walker; Brian M Jeong; Kiwon Nam; Bruce S Bochner; Hiam Abdala-Valencia; Sergejs Berdnikovs Journal: J Immunol Date: 2019-12-09 Impact factor: 5.422