Hernia disease and collagen gene regulation: are there clues for intervention?

Jansen, Petra Lynen; Klinge, U.; Mertens, Peter R.

doi:10.1007/s10029-006-0147-6

Cited by 22 publications

(8 citation statements)

References 29 publications

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“…This development has been previously described by Knight et al [26]. An increased amount of premature collagen type III is present in the early phase of wound healing which is later on being replaced by highly cross-linked and stable collagen type I [27]. A high collagen I/III ratio shows the maturing of the scar tissue, therefore demonstrating an adequate wound healing [15].…”

Section: Discussionmentioning

confidence: 65%

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

et al. 2015

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Background: Biocompatibility and tissue integration of a surgical suture are decisive factors for wound healing and therefore for the success of sutures. The optimal suture material is still under discussion. Polyvinylidene fluoride (PVDF) is described to have superior properties of biocompatibility and is therefore frequently used as a mesh component. Only little information is available about its use as a suture material. The aim of this study was to evaluate the biocompatibility of PVDF as a suture material in comparison to 5 different established sutures in a rat model. Methods: In 30 male rats, a monofilamental PVDF suture (Resopren®) and 5 established control suture materials [polyester (Miralene®), polytetrafluoroethylene (Gore®), poliglecaprone (Monocryl®), polydioxanone (Monoplus®), polyglactin 910 (Vicryl®), USP size 3-0] were placed in the subcutaneous layer of the abdominal wall without knot or tension. After 3, 7 or 21 days, the abdominal walls were explanted for histopathological and immunohistochemical investigation with special regard to the size and quality of foreign body granuloma and the length of the comet tail-like infiltrate (CTI). Results: The PVDF sutures showed the smallest size of foreign body granuloma (60 ± 14 µm) and the smallest CTI length (343 ± 60 µm) of all polymers after 21 days. Only PVDF (Resopren) and polydioxanone (Monoplus) showed a significant collagen I/III ratio increase between days 3 and 21 (p = 0.009 and p = 0.016). The quality of foreign body reaction regarding inflammation, proliferation and fibrotic remodeling was similar between all suture materials. Conclusions: Our data indicate that monofilamental PVDF sutures show a favorable foreign body reaction with small granuloma sizes and CTI length in comparison to established sutures. Its use as a suture material in general surgery could therefore be extended in the future. To reinforce these findings, further clinical studies need to be conducted.

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Section: Discussionmentioning

confidence: 65%

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

et al. 2015

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“…A previously developed plasma coating strategy to optimize biocompatibility of meshes seems not to influence this early inflammatory reaction and inflammatory infiltrate formation but more so to influence mid- and long-term processes which lead to neovascularization, collagen fibre organisation. It has been shown that premature type III collagen is predominantly synthesized in early phases of wound healing and in the presence of inflammatory cells [15]. Collagen III is then replaced by highly cross-linked and stable collagen type I later after implantation.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Reaction as Determinant of Foreign Body Reaction Is an Early and Susceptible Event after Mesh Implantation

Gerullis

Georgas

Boros

et al. 2014

BioMed Research International

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Purpose. To investigate and relate the ultrashort-term and long-term courses of determinants for foreign body reaction as biocompatibility predictors for meshes in an animal model. Materials and Methods. Three different meshes (TVT, UltraPro, and PVDF) were implanted in sheep. Native and plasma coated meshes were placed bilaterally: (a) interaperitoneally, (b) as fascia onlay, and (c) as muscle onlay (fascia sublay). At 5 min, 20 min, 60 min, and 120 min meshes were explanted and histochemically investigated for inflammatory infiltrate, macrophage infiltration, vessel formation, myofibroblast invasion, and connective tissue accumulation. The results were related to long-term values over 24 months. Results. Macrophage invasion reached highest extents with up to 60% in short-term and decreased within 24 months to about 30%. Inflammatory infiltrate increased within the first 2 hours, the reached levels and the different extents and ranking among the investigated meshes remained stable during long-term follow up. For myofibroblasts, connective tissue, and CD31+ cells, no activity was detected during the first 120 min. Conclusion. The local inflammatory reaction is an early and susceptible event after mesh implantation. It cannot be influenced by prior plasma coating and does not depend on the localisation of implantation.

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“…The study of hernias provides vast field of research on the cellular mechanisms, mutations and the ability to form collagen tissue, as well as on environmental factors and genetic alterations of this regulation, which are essential for proper postoperative healing. The progressive decrease of collagen with age, the changes of its ultrastructure, the further degradation and increased matrix proteases that accompany aging are also extensively studied, but several aspects not yet completely elucidated justify complementary research 13 15 26 . An important aspect of these studies is related to technologies involving the biophotonics, with laser employment (light amplification by stimulated emission of radiation), being an increasingly used option 30 .…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative adhesions represent a complex problem after the manipulation of the abdominal cavity 2 3 10 14 28 or situations that are accompanied by peritonitis 8 . Environmental factors such as smoking, factors that are inherent to the patient as obesity and genetics, as well as local complications of the incision, with wound infection, are important to the development of incisional hernias 13 15 26 . Published articles on the various options of synthetic prostheses used in the repair of such hernias 1 3 9 18 19 22 23 29 show that even the state-of-the-art materials, developed for direct contact with the abdominal cavity, despite decreasing, they can not completely prevent the formation of adhesions on these prostheses 4 22 23 25 , demonstrating that these materials need to be improved.…”

Section: Discussionmentioning

confidence: 99%

Critical Analysis of Experimental Model for Study of Adhesions After Incisional Hernias Induced in Rats’ and Repair of Abdominal Wall With Different Biomaterials

Serigiolle¹,

Barbieri²,

Gomes³

et al. 2015

ABCD, arq. bras. cir. dig.

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Background: Adhesions induced by biomaterials experimentally implanted in the abdominal cavity are basically studied by primary repair of different abdominal wall defects or by the correction of incisional hernias previously performed with no precise definition of the most appropriate model. Aim: To describe the adhesions which occur after the development of incisional hernias, before the prosthesis implantation, in an experimental model to study the changes induced by different meshes. Methods: Incisional hernias were performed in 10 rats with hernia orifices of standardized dimensions, obtained by the median incision of the abdominal wall and eversion of the defect edges. Ten days after the procedure adhesions of abdominal structures were found when hernias were repaired with different meshes. Results: The results showed hernia sac well defined in all rats ten days after the initial procedure. Adhesions of the greater omentum occurred in five animals of which two also showed adhesions of small bowel loops besides the omentum, and another two showed liver adhesions as well as the greater omentum, numbers with statistical significance by Student's t test (p<0.05). Conclusion: Although it reproduces the real clinical situation, the choice of experimental model of incisional hernia repair previously induced implies important adhesions, with possible repercussions in the evaluation of the second operation, when different implants of synthetic materials are used.

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Hernia disease and collagen gene regulation: are there clues for intervention?

Cited by 22 publications

References 29 publications

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

Inflammatory Reaction as Determinant of Foreign Body Reaction Is an Early and Susceptible Event after Mesh Implantation

Critical Analysis of Experimental Model for Study of Adhesions After Incisional Hernias Induced in Rats’ and Repair of Abdominal Wall With Different Biomaterials

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