Analysis of resorbable mesh implants in short-term human muscular fascia cultures: a pilot study
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ORIGINAL ARTICLE
Analysis of resorbable mesh implants in short‑term human muscular fascia cultures: a pilot study V. Trapani1 · G. Bagni2 · M. Piccoli1 · I. Roli1 · F. Di Patti3,4 · A. Arcangeli2,4 Received: 8 February 2020 / Accepted: 16 July 2020 © The Author(s) 2020
Abstract Purpose Alteration in fascial tissue collagen composition represents a key factor in hernia etiology and recurrence. Both resorbable and non-resorbable meshes for hernia repair are currently used in the surgical setting. However, no study has investigated so far the role of different implant materials on collagen deposition and tissue remodeling in human fascia. The aim of the present study was to develop a novel ex vivo model of human soft tissue repair mesh implant, and to test its suitability to investigate the effects of different materials on tissue remodeling and collagen composition. Methods Resorbable poly-4-hydroxybutyrate and non-resorbable polypropylene mesh implants were embedded in human abdominal fascia samples, mimicking common surgical procedures. Calcein-AM/Propidium Iodide vital staining was used to assess tissue vitality. Tissue morphology was evaluated using Mallory trichrome and hematoxylin and eosin staining. Collagen type I and III expression was determined through immunostaining semi-quantification by color deconvolution. All analyses were performed after 54 days of culture. Results The established ex vivo model showed good viability at 54 days of culture, confirming both culture method feasibility and implants biocompatibility. Both mesh implants induced a disorganization of collagen fibers pattern. A statistically significantly higher collagen I/III ratio was detected in fascial tissue samples cultured with resorbable implants compared to either non-resorbable implants or meshes-free controls. Conclusion We developed a novel ex vivo model and provided evidence that resorbable polyhydroxybutyrate meshes display better biomechanical properties suitable for proper restoration in surgical hernia repair. Keywords Hernia · Ex vivo model · Collagen I · Collagen III · Polyhydroxybutyrate · Polypropylene
Introduction
V. Trapani and G. Bagni have equally contributed to the manuscript. * A. Arcangeli [email protected] 1
Department of General and Emergency Surgery, New Sant’Agostino-Estense Hospital NOCSAE, via Pietro Giardini 1355, Baggiovara, Modena, Italy
2
Department of Experimental and Clinical Medicine, Section of Internal Medicine, University of Florence, viale GB Morgagni 50, 50134 Florence, Italy
3
Department of Physics, University of Florence, Sesto Fiorentino, Florence, Italy
4
CSDC-Center for the Study of Complex Dynamics, Sesto Fiorentino, 50019 Florence, Italy
Reinforcement of the abdominal wall with mesh implants is the most widely applied and established procedure in abdominal hernia surgical repair procedures. Both nonresorbable and fully resorbable soft tissue repair implants are currently available. The latter accounts for the strength of a synthetic mesh, and shows the re
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