Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction: a randomized trial study in a rabbit model
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 thei...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-11-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-22190-4 |
| _version_ | 1811207766981738496 |
|---|---|
| author | Marta Pero Cristina Castells-Sala Leticia Alserawan Laura Casani Josep Oriol Juan Babot Ignasi Jorba Maria Luisa Pérez Esther Moga Jorge Otero Patricia López-Chicón Lina Badimon Anna Vilarrodona Serrat Oriol Porta-Roda |
| author_facet | Marta Pero Cristina Castells-Sala Leticia Alserawan Laura Casani Josep Oriol Juan Babot Ignasi Jorba Maria Luisa Pérez Esther Moga Jorge Otero Patricia López-Chicón Lina Badimon Anna Vilarrodona Serrat Oriol Porta-Roda |
| author_sort | Marta Pero |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T04:10:21Z |
| format | Article |
| id | doaj.art-edba656122fa4c238dd522068615c011 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T04:10:21Z |
| publishDate | 2022-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-edba656122fa4c238dd522068615c0112022-12-22T03:48:31ZengNature PortfolioScientific Reports2045-23222022-11-011211810.1038/s41598-022-22190-4Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction: a randomized trial study in a rabbit modelMarta Pero0Cristina Castells-Sala1Leticia Alserawan2Laura Casani3Josep Oriol Juan Babot4Ignasi Jorba5Maria Luisa Pérez6Esther Moga7Jorge Otero8Patricia López-Chicón9Lina Badimon10Anna Vilarrodona Serrat11Oriol Porta-Roda12Department of Obstetrics and Gynecology, Hospital de La Santa Creu I Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de BarcelonaBiomedical Research Institute Sant Pau (IIB Sant Pau)Department of Immunology, Hospital Clinic de BarcelonaBiomedical Research Institute Sant Pau (IIB Sant Pau)Biomedical Research Institute Sant Pau (IIB Sant Pau)Department of Biomedical Engineering, Institute for Complex Molecular Systems (ICMS), Eindhoven University of TechnologyBarcelona Tissue Bank. Banc de Sang I Teixits (BST)Department of Immunology, Hospital de La Santa Creu I Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de BarcelonaBiophysics and Bioengineering Unit, University of BarcelonaBiomedical Research Institute Sant Pau (IIB Sant Pau)Biomedical Research Institute Sant Pau (IIB Sant Pau)Barcelona Tissue Bank. Banc de Sang I Teixits (BST)Department of Obstetrics and Gynecology, Hospital Universitari Mútua Terrassa, Universitat de BarcelonaAbstract 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.https://doi.org/10.1038/s41598-022-22190-4 |
| spellingShingle | Marta Pero Cristina Castells-Sala Leticia Alserawan Laura Casani Josep Oriol Juan Babot Ignasi Jorba Maria Luisa Pérez Esther Moga Jorge Otero Patricia López-Chicón Lina Badimon Anna Vilarrodona Serrat Oriol Porta-Roda Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction: a randomized trial study in a rabbit model Scientific Reports |
| title | Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction: a randomized trial study in a rabbit model |
| title_full | Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction: a randomized trial study in a rabbit model |
| title_fullStr | Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction: a randomized trial study in a rabbit model |
| title_full_unstemmed | Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction: a randomized trial study in a rabbit model |
| title_short | Comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction: a randomized trial study in a rabbit model |
| title_sort | comparison of a human acellular dermal matrix and a polypropylene mesh for pelvic floor reconstruction a randomized trial study in a rabbit model |
| url | https://doi.org/10.1038/s41598-022-22190-4 |
| work_keys_str_mv | AT martapero comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT cristinacastellssala comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT leticiaalserawan comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT lauracasani comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT joseporioljuanbabot comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT ignasijorba comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT marialuisaperez comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT esthermoga comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT jorgeotero comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT patricialopezchicon comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT linabadimon comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT annavilarrodonaserrat comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel AT oriolportaroda comparisonofahumanacellulardermalmatrixandapolypropylenemeshforpelvicfloorreconstructionarandomizedtrialstudyinarabbitmodel |