Onlay Mesh with P4HB Provides Superior Outcomes in Complex Abdominal Wall Reconstruction

Levy, Adam; Bogue, Jarrod T; Morrison, Kerry A.; Lieberman, Michael D.; Pomp, Alfons; Spector, Jason A.

doi:10.1016/j.jamcollsurg.2016.08.273

Cited by 2 publications

(2 citation statements)

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“…Clinical studies as well as in vivo animal studies have suggested that the use of P4HB may enhance the host defense response against microbial infections [6,[66][67][68]. In our in vitro platform, P4HB mesh affected the expression of genes annotated in the pathogen response pathway for all Mϕ polarizations, as seen in figure 3(C), but the specific mechanism has yet to be determined.…”

Section: Discussionmentioning

confidence: 91%

Transcriptome-targeted analysis of human peripheral blood-derived macrophages when cultured on biomaterial meshes

et al. 2021

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Surgical meshes are commonly used to repair defects and support soft tissues. Macrophages (Mφs) are critical cells in the wound healing process and are involved in the host response upon foreign biomaterials. There are various commercially available permanent and absorbable meshes used by surgeons for surgical interventions. Polypropylene (PP) meshes represent a permanent biomaterial that can elicit both inflammatory and anti-inflammatory responses. In contrast, poly-4-hydroxybutyrate (P4HB) based meshes are absorbable and linked to positive clinical outcomes but have a poorly characterized immune response. This study evaluated the in vitro targeted transcriptomic response of human Mφs seeded for 48 h on PP and P4HB surgical meshes. The in vitro measured response from human Mφs cultured on P4HB exhibited inflammatory and anti-inflammatory gene expression profiles typically associated with wound healing, which aligns with in vivo animal studies from literature. The work herein provides in vitro evidence for the early transcriptomic targeted signature of human Mφs upon two commonly used surgical meshes. The findings suggest a transition from an inflammatory to a non-inflammatory phenotype by P4HB as well as an upregulation of genes annotated under the pathogen response pathway.

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Section: Discussionmentioning

confidence: 91%

Transcriptome-targeted analysis of human peripheral blood-derived macrophages when cultured on biomaterial meshes

et al. 2021

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“…Long-term biosynthetic absorbable (LTBA) mesh LTBA formed using a degradable biosynthetic polymer is designed to leverage the benefits and minimise the deficiencies of existing synthetic and biologic mesh types [4,5]. There are several terms to describe this mesh, including 'absorbable synthetic mesh', 'resorbable synthetic mesh', 'absorbable biosynthetic surgical mesh', and 'biosynthetic mesh'.…”

Section: Biologic Meshmentioning

confidence: 99%

Establishing Peer Consensus About the Use of Long‐Term Biosynthetic Absorbable Mesh for Hernia (Grades 2–3) as the Standard of Care

et al. 2022

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Background Standard synthetic and biologic meshes, often used in hernia repair, have commonly been used and each have their strengths but associated drawbacks. Long‐term biosynthetic absorbable (LTBA) mesh has been developed to combine the strengths of synthetic and biologic meshes without the associated weaknesses. As a newer type of mesh, the supporting evidence base is still growing, and their optimum use has yet to be defined. This consensus was initiated to provide insight into those situations where a LTBA might be considered the Standard of Care in ventral hernia repair grades 2–3 (original classification, 2010) of the Ventral Hernia Working Group. Methods A steering group of expert surgeons identified 35 statements, based around the evidence supporting LTBA, surgical technique, patients type most suitable for LTBA, risk–benefit of LTBA, patient and surgeon considerations, LTBA value. Surgeons involved in hernia repair received an online survey to assess consensus with these statements. Consensus was defined as high if ≥ 70% and very high if ≥ 90% of respondents agreed. Statements that had not achieved consensus agreement were revised and these were then issued for a subsequent round. Finally, 34 statements were included. Results Two hundred fifty‐five surgeons were involved. Fourteen statements (41%) achieved very high consensus, 24 achieved consensuses (≥ 70–< 90%), whilst one (3%) just failed to achieve consensus with an agreement score of 69%. Conclusions Expert consensus opinion about the use of LTBA for hernia (Grades 2–3) as the Standard of Care was achieved. Based on the consensus scores, the steering group derived eleven keys.

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Onlay Mesh with P4HB Provides Superior Outcomes in Complex Abdominal Wall Reconstruction

Cited by 2 publications

References 0 publications

Transcriptome-targeted analysis of human peripheral blood-derived macrophages when cultured on biomaterial meshes

Transcriptome-targeted analysis of human peripheral blood-derived macrophages when cultured on biomaterial meshes

Establishing Peer Consensus About the Use of Long‐Term Biosynthetic Absorbable Mesh for Hernia (Grades 2–3) as the Standard of Care

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