Remodeling characteristics and biomechanical properties of a crosslinked versus a non-crosslinked porcine dermis scaffolds in a porcine model of ventral hernia repair

PurposeThe objective of this study was to evaluate the histologic remodeling profile and biomechanical properties of the porcine abdominal wall after repair with HDMI-crosslinked (Permacol®) or non-crosslinked (Strattice®) porcine dermis in a porcine model of ventral hernia repair.MethodsBilateral incisional hernias were created in Yucatan minipigs and repaired after 21 days. The repair site, including mesh and abdominal wall, was harvested after 1, 6, and 12 months and subjected to histologic analysis and uniaxial testing. Native abdominal wall without mesh was also subjected to uniaxial tensile testing.ResultsPermacol® demonstrated significant improvement over time in every remodeling category except scaffold degradation, while remodeling characteristics of Strattice® remained relatively unchanged over time for every category except fibrous encapsulation and neovascularization. However, remodeling scores for Strattice® were already significantly higher after just 1 month compared to Permacol® in the categories of cellular infiltration, ECM deposition, and neovascularization, providing evidence of earlier remodeling of the non-crosslinked grafts compared to the crosslinked grafts. The tensile strength and stiffness of both crosslinked and non-crosslinked graft-tissue composites were greater than the tensile strength and stiffness of the native porcine abdominal wall in the very early post-operative period (1 month), but there was no difference in tensile strength or stiffness by the end of the study period (12 months).ConclusionsHDMI collagen crosslinking of porcine dermis scaffolds reduces the early histologic remodeling profile but does not significantly impact the tensile strength or stiffness of the graft-tissue composites in a porcine model of ventral hernia repair.

[1]  B. Klosterhalfen,et al.  Abnormal Collagen I to III Distribution in the Skin of Patients with Incisional Hernia , 2000, European Surgical Research.

[2]  D. Vargo,et al.  Acellular dermal matrix in the management of high-risk abdominal wall defects. , 2006, American journal of surgery.

[3]  S. Badylak,et al.  Extracellular matrix as a biological scaffold material: Structure and function. , 2009, Acta biomaterialia.

[4]  D. Skeete,et al.  Use of human acellular dermal matrix for abdominal wall reconstructions. , 2009, American journal of surgery.

[5]  Yen Chang,et al.  Effects of crosslinking degree of an acellular biological tissue on its tissue regeneration pattern. , 2004, Biomaterials.

[6]  B. Matthews,et al.  Evaluation of intraperitoneal placement of absorbable and nonabsorbable barrier coated mesh secured with fibrin sealant in a New Zealand white rabbit model , 2011, Surgical Endoscopy.

[7]  Stephen F Badylak,et al.  The extracellular matrix as a biologic scaffold material. , 2007, Biomaterials.

[8]  Donald O Freytes,et al.  Reprint of: Extracellular matrix as a biological scaffold material: Structure and function. , 2015, Acta biomaterialia.

[9]  P. Sibbons,et al.  Effect of crosslinking on the performance of a collagen-derived biomaterial as an implant for soft tissue repair: a rodent model. , 2010, Journal of biomedical materials research. Part B, Applied biomaterials.

[10]  Stephen F Badylak,et al.  Xenogeneic extracellular matrix as a scaffold for tissue reconstruction. , 2004, Transplant immunology.

[11]  George P McCabe,et al.  Extracellular matrix bioscaffolds for orthopaedic applications. A comparative histologic study. , 2006, The Journal of bone and joint surgery. American volume.

[12]  B. Matthews,et al.  Histologic and biomechanical evaluation of crosslinked and non-crosslinked biologic meshes in a porcine model of ventral incisional hernia repair. , 2011, Journal of the American College of Surgeons.

[13]  A. Landsman,et al.  Extracellular matrix biomaterials for soft tissue repair. , 2009, Clinics in podiatric medicine and surgery.

[14]  M. Rosen,et al.  Bacterial clearance of biologic grafts used in hernia repair: an experimental study , 2011, Surgical Endoscopy.

[15]  J. Patton,et al.  Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions. , 2007, American journal of surgery.

[16]  B. Matthews,et al.  Early biocompatibility of crosslinked and non-crosslinked biologic meshes in a porcine model of ventral hernia repair , 2011, Hernia.