Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction : a randomized trial study in a rabbit model
Peró, Marta (Institut d'Investigació Biomèdica Sant Pau)
Castells-Sala, Cristina (Institut d'Investigació Biomèdica Sant Pau)
Alserawan, Leticia (Hospital Clínic i Provincial de Barcelona)
Casaní, Laura (Institut d'Investigació Biomèdica Sant Pau)
Juan Babot, Josep Oriol (Institut d'Investigació Biomèdica Sant Pau)
Jorba, Ignasi (Eindhoven University of Technology. Department of Biomedical Engineering, Institute for Complex Molecular Systems (ICMS))
Pérez, Maria Luisa (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Moga, Esther (Institut d'Investigació Biomèdica Sant Pau)
Otero, Jorge (Universitat de Barcelona)
López-Chicón, Patricia (Institut d'Investigació Biomèdica Sant Pau)
Badimon, Lina (Institut d'Investigació Biomèdica Sant Pau)
Vilarrodona, Anna (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Porta-Roda, Oriol (Universitat de Barcelona. Hospital Mútua de Terrassa)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Non-absorbable polypropylene (PP) meshes have been widely used in surgical reconstruction of the pelvic floor disorders. However, they are associated with serious complications. Human acellular dermal matrices (hADM) have demonstrated safety and efficacy in reconstructive medicine, but their suitability and efficacy at vaginal level is not known. This study compares the biological performance of PP mesh and a newly developed hADM. 20 rabbits were randomized to receive the hADM graft or the PP mesh. Grafts were surgically implanted in the abdominal wall and vagina. After 180 days, grafts were explanted and evaluated. The vaginal mesh extrusion rate was higher in the PP group (33% vs. 0%, p = 0. 015). Full integration of the vaginal grafts was more frequent in the hADM group, where 35% of the grafts were difficult to recognize. In the PP group, the vaginal mesh was identified in 100% of the animals (p = 0. 014). In PP group, the infiltrates had a focal distribution and were mostly located in the internal part of the epithelium, while in the hADM group, the infiltrates had a diffuse distribution. Additionally, the hADM group also presented more B-lymphocytes and less T-lymphocytes. Biomechanical analysis showed that hADM had lower resistance to stress. Moreover, PP mesh stiffness and elasticity were higher. Then, hADM is associated with fewer clinical complications, as well as better tissue integration. However, it shows greater incorporation into the surrounding native tissue, especially in the vaginal location, undergoing a reduction in its biomechanical properties 6 months after implantation.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Experimental models of disease ; Implants ; Tissues ; Regenerative medicine ; Tissue engineering ; Sexual dysfunction ; Urinary incontinence ; Reconstruction ; Outcomes research ; Preclinical research ; Translational research ; Chronic inflammation
Published in:	Scientific reports, Vol. 12 (november 2022) , ISSN 2045-2322

DOI: 10.1038/s41598-022-22190-4
PMID: 36450745

8 p, 1.3 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles