In-vivo evaluation of a reinforced ovine biologic: a comparative study to available hernia mesh repair materials

Abstract

Purpose Two innovative reinforced biologic materials were studied in a non-human primate hernia repair model. The test articles, which combine layers of ovine decellularized extracellular matrix with minimal amounts of synthetic polymer, were evaluated for their biologic performance as measured by inflammatory response, healing kinetics, integration, and remodeling into functional host tissue. For comparison, seven clinically used biologic and synthetic meshes were also studied. Methods Animals were implanted with test articles in surgically created full-thickness midline abdominal wall defects, and evaluated macroscopically and histologically at 4, 12, and 24 weeks. Results Macroscopically, biologics resorbed and remodeled into naturally appearing tissue; the reinforced biologics appeared similar, but remodeled earlier and were less prone to stretch. Synthetics developed a layer of reactive tissue above and separate from the contracted mesh structure. At early time points, the collagen networks of biologics and reinforced biologics were infiltrated by host cells primarily as a peripheral layer on the biologics. As early as 12 weeks, the collagen networks associated with the reinforced biologics remodeled into organized host collagen. By 24 weeks, both reinforced biologics and biologics had low levels of inflammation. In contrast, a foreign body response persisted at 24 weeks with the synthetics, which had developed less organized collagen, separate in space from the actual mesh. Conclusions The current study shows a favorable response to reinforced biologics, which were associated with an initial inflammatory response, resolving by later time points, followed by active remodeling, and the formation of new morphologically functional collagen.

A novel chemotactic factor derived from the extracellular matrix protein decorin recruits mesenchymal stromal cells in vitro and in vivo

“…Ovine forestomach matrix (OFM) is a dECM derived from the rumen of sheep, specially the propria submucosa, and has been shown to contain a number of ECM proteins including 24 different collagens, proteoglycans, including perlecan and decorin (DCN), cytokines and growth factors [ 22 , 23 ]. In vivo studies have demonstrated that OFM is anti-inflammatory [ 24 ], stimulates angiogenesis [ 25 ] and is remodeled over time [ 26 ]. Clinically, OFM has found a range of applications in soft tissue repair, including wound healing [ 27 – 33 ], reconstructive surgery [ 34 ], and abdominal wall repair [ 35 ].…”

Extracellular matrix graft for the surgical management of Hurley stage III hidradenitis suppurativa: a pilot case series

“…15,23 The OFM bioscaffold has been shown to inhibit MMPs and neutrophil elastase, 16 and undergoes constructive remodelling in vivo, consistent with an antiinflammatory response. 15,18,24 Wide excision of HS-affected tissue leaves a significant full-thickness defect which, left to heal via secondary intention, may result in significant scar contracture and loss of functional status of the affected area. Dermal substitutes have been part of the reconstructive ladder for many years, although their use in HS reconstruction is limited relative to their widespread use in applications such as burns, necrotising fasciitis, trauma and wounds.…”

Extracellular matrix graft for reconstruction over exposed structures: a pilot case series

“…6 Additionally, structural studies demonstrate that OFM retains a native matrix architecture similar to the ECM of healthy human skin. 9 This structural and compositional mimicry of healthy tissue ECM facilitates a range of biological properties, for example OFM to inhibit a range of tissue proteases, 21 and stimulate cell migration, infiltration, proliferation and differentiation, 7,8,22 and the recruitment of mesenchymal stromal cells. 10 In comparison to a synthetic dermal matrix, such as reconstituted collagen/ glycosaminoglycan, the OFM graft is expected to impart greater biological functionality, attributed to a preserved ECM structure and composition.…”