Characterization of poly-4-hydroxybutyrate mesh for hernia repair applications

Martin, David P.; Badhwar, Amit; Shah, Devang V.; Rizk, Said; Eldridge, Stephen N.; Gagne, Darcy H.; Ganatra, Amit; Darois, Roger E.; Williams, Simon F.; Tai, Hsin-Chien; Scott, Jeffrey R.

doi:10.1016/j.jss.2013.03.044

Cited by 112 publications

(89 citation statements)

References 11 publications

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“…The results of this study compare well with similar, previously published studies [24, 25, 27, 32]. In 2013, Deeken et al evaluated Phasix™ in a porcine model of hernia repair at 6, 12, 26, and 52 weeks postimplantation.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair

et al. 2016

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BackgroundThe objective of this study was to evaluate the mechanical and histological properties of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh (Phasix™ ST) compared to partially absorbable (Ventralight™ ST), fully absorbable (Phasix™), and biologically derived (Strattice™) meshes in a porcine model of ventral hernia repair.MethodsBilateral abdominal surgical defects were created in twenty-four Yucatan pigs, repaired with intraperitoneal (Phasix™ ST, Ventralight™ ST) or retromuscular (Phasix™, Strattice™) mesh, and evaluated at 12 and 24 weeks (n = 6 mesh/group/time point).ResultsPrior to implantation, Strattice™ demonstrated significantly higher (p < 0.001) strength (636.6 ± 192.1 N) compared to Ventralight™ ST (324.3 ± 37.1 N), Phasix™ ST (206.9 ± 11.3 N), and Phasix™ (200.6 ± 25.2 N). At 12 and 24 weeks, mesh/repair strength was significantly greater than NAW (p < 0.01 in all cases), and no significant changes in strength were observed for any meshes between 12 and 24 weeks (p > 0.05). Phasix™ mesh/repair strength was significantly greater than Strattice™ (p < 0.001) at 12 and 24 weeks, and Ventralight™ ST mesh/repair strength was significantly greater than Phasix™ ST mesh (p < 0.05) at 24 weeks. At 12 and 24 weeks, Phasix™ ST and Ventralight™ ST were associated with mild inflammation and minimal–mild fibrosis/neovascularization, with no significant differences between groups. At both time points, Phasix™ was associated with minimal–mild inflammation/fibrosis and mild neovascularization. Strattice™ was associated with minimal inflammation/fibrosis, with minimal neovascularization at 12 weeks, which increased to mild by 24 weeks. Strattice™ exhibited significantly less neovascularization than Phasix™ at 12 weeks and significantly greater inflammation at 24 weeks due to remodeling.ConclusionsPhasix™ ST demonstrated mechanical and histological properties comparable to partially absorbable (Ventralight™ ST) and fully resorbable (Phasix™) meshes at 12 and 24 weeks in this model. Data also suggest that fully absorbable meshes with longer-term resorption profiles may provide improved mechanical and histological properties compared to biologically derived scaffolds.

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Section: Discussionsupporting

confidence: 87%

Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair

et al. 2016

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“…Bioabsorbable mesh is a fully resorbable synthetic mesh. 124 In theory, bioabsorbable mesh allows for ingrowth of native host tissue that will eventually be able to provide support on its own, without the mesh. 124 There is no high quality published evidence to support the safety or efficacy of bioabsorbable mesh in contaminated fields.…”

Section: Mesh Repairmentioning

confidence: 99%

Ventral hernia: Patient selection, treatment, and management

Holihan

Alawadi

Harris

et al. 2016

Current Problems in Surgery

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“…For example, Gore Bio-A (WL Gore and Associates, USA) mesh degrades in six months and has been shown to reduce recurrence rates, infection and pain (23,28,29). Phasix (Bard Davol Inc, USA) (23,30) and Tigr Matrix (Novus Scientific, USA) (31-33) also degrade over several months and are useful in hernia repair, as has been demonstrated in preclinical animal (23,31,32) and human pilot (33) studies. The long-term effectiveness of these newer synthetic degradable meshes remains to be tested in clinical practice.…”

Section: Classes Of Meshmentioning

confidence: 99%