Doxycycline administration improves fascial interface in hernia repair

Tharappel, Job C.; Bower, Curtis E.; Harris, Jennifer W.; Ramineni, Sandeep K.; Puleo, David A.; Roth, J. Scott

doi:10.1016/j.jss.2014.05.013

Cited by 12 publications

(9 citation statements)

References 31 publications

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“…To command post‐implantation FBR, various anti‐inflammatory drugs have been loaded on meshes (i.e., cortisone, non‐steroidal anti‐inflammatory drugs (NSAID, e.g., ibuprofen) or tetracycline . For instance, local release of cortisone limited the inflammatory reaction, correlating with a reduction in the granuloma size and an improvement of the neovascularization .…”

Section: Anti‐inflammatory Meshmentioning

confidence: 99%

“…For instance, local release of cortisone limited the inflammatory reaction, correlating with a reduction in the granuloma size and an improvement of the neovascularization . Another candidate (i.e., doxycycline) was administered systemically or incubated with meshes prior to implantation and resulted in improved quality of scar formation (increased ratio of collagen I/III) and in an efficient regulation of MMP secretion.…”

Section: Anti‐inflammatory Meshmentioning

confidence: 99%

See 1 more Smart Citation

Emerging Trends in Abdominal Wall Reinforcement: Bringing Bio‐Functionality to Meshes

Guillaume

Teuschl

Gruber-Blum

et al. 2015

Adv Healthcare Materials

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Abdominal wall hernia is a recurrent issue world-wide and requires the implantation of over 1 million meshes per year. Because permanent meshes such as polypropylene and polyester are not free of complications after implantation, many mesh modifications and new functionalities have been investigated over the last decade. Indeed, mesh optimization is the focus of intense development and the biomaterials utilized are now envisioned as being bioactive substrates that trigger various physiological processes in order to prevent complications and to promote tissue integration. In this context, it is of paramount interest to review the most relevant bio-functionalities being brought to new meshes and to open new avenues for the innovative development of the next generation of meshes with enhanced properties for functional abdominal wall hernia repair.

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Section: Anti‐inflammatory Meshmentioning

confidence: 99%

Section: Anti‐inflammatory Meshmentioning

confidence: 99%

Emerging Trends in Abdominal Wall Reinforcement: Bringing Bio‐Functionality to Meshes

Guillaume

Teuschl

Gruber-Blum

et al. 2015

Adv Healthcare Materials

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“…In comparison, a study carried out by Odula and Kakande (2004) at Mulago National Referral Hospital in Uganda indicated a 30.8% rate of post-operative complications arising from wound infections, hemorrhages, and chest infections associated with hernia repair. Tharappel et al (2014) also reported high rate of recurrence of hernias as a persisting problem despite advancements in prosthetic materials technology and surgical procedures in the western world. Hernia surgery may impair testicular function and may ultimately affect male fertility (Beddy et al 2006, Tekatli et al 2012.…”

Section: Ethnobotany Research and Applications 290mentioning

confidence: 99%

“…Patients with inguinal hernia have been shown to have a defective collagen synthesis mechanism coupled with changes in the ratios of the types of collagen. This renders the abdominal sinews weaker, making them more prone to hernias (Ajabnoor et al 1992, Rosch et al 2002, Tharappel 2014, Wagh & Read 1972.…”

Section: Possible Mechanism Of Action Of Some Of the Plants Used To Tmentioning

confidence: 99%

Medicinal Plant Species Used in the Management of Hernia by Traditional Medicine Practitioners in Central Uganda

Kibuuka

Anywar

2015

Ethnobot. Res. App.

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“…35 In an in vivo experimental model of incisional hernia repair in rats, doxycycline decreased gelatinases MMP-2 and MMP-9 with significantly improved tensile strength of excised fascial interface tissue and increased collagen I/III ratios. 36 The small molecule, hydroxamate MMP inhibitor GM6001, also called Galardin or Ilomastat, was first described by Galardy and co-authors in 1994. 37 GM6001 is a broad-spectrum MMP inhibitor that chelates with the active zinc-atom of the enzyme's catalytic centre with consequent inactivation of the enzyme.…”

Section: Introductionmentioning

confidence: 99%

Influence of MMP inhibitor GM6001 loading of fibre coated polypropylene meshes on wound healing: Implications for hernia repair

Böhm

Groll²,

Heffels³

et al. 2018

J Biomater Appl

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Polypropylene meshes are standard for hernia repair. Matrix metalloproteinases play a central role in inflammation. To reduce the inflammatory response and improve remodelling with an associated reduction of hernia recurrence, we modified polypropylene meshes by nanofibre coating and saturation with the broad-spectrum matrix metalloproteinase inhibitor GM6001. The aim was to modulate the inflammatory reaction, increase collagen deposition and improve mesh biointegration. Polypropylene meshes were surface-modified with star-configured NCO-sP(EO -stat-PO) and covered with electrospun nanofibres (polypropylene-nano) and GM6001 (polypropylene-nano-GM). In a hernia model, defects were reconstructed with one of the meshes. Inflammation, neovascularization, bio-integration, proliferation and apoptosis were assessed histologically, collagen content and gelatinases biochemically. Mesh surface modification resulted in higher inflammatory response compared to polypropylene. Pro-inflammatory matrix metalloproteinase-9 paralleled findings while GM6001 reduced matrix metalloproteinase-9 significantly. Significantly increased matrix metalloproteinase-2 beneficial for remodelling was noted with polypropylene-nano-meshes. Increased vascular endothelial growth factor, neo-vascularization and collagen content were measured in polypropylene-nano-meshes compared to polypropylene. GM6001 significantly reduced myofibroblasts. This effect ended after d14 due to engineering limitations with release of maximal GM6001 loading. Nanofibre-coating of polypropylene-meshes confers better tissue vascularization to the cost of increased inflammation. This phenomenon can be only partially compensated by GM6001. Future research will enable higher GM6001 uptake in nano-coated meshes and may alter mesh biointegration in a more pronounced way.

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Doxycycline administration improves fascial interface in hernia repair

Cited by 12 publications

References 31 publications

Emerging Trends in Abdominal Wall Reinforcement: Bringing Bio‐Functionality to Meshes

Emerging Trends in Abdominal Wall Reinforcement: Bringing Bio‐Functionality to Meshes

Medicinal Plant Species Used in the Management of Hernia by Traditional Medicine Practitioners in Central Uganda

Influence of MMP inhibitor GM6001 loading of fibre coated polypropylene meshes on wound healing: Implications for hernia repair

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