Stem cell augmented mesh materials: an in vitro and in vivo study.

INTRODUCTION AND HYPOTHESIS: To test in vitro and in vivo the capability of mesh materials to act as scaffolds for rat-derived mesenchymal stem cells (rMSCs) and to compare inflammatory response and collagen characteristics of implant materials, either seeded or not with rMSCs. METHODS: rMSCs isolated from rat bone marrow were seeded and cultured in vitro on four different implant materials. Implants showing the best rMSC proliferation rate were selected for the in vivo experiment. Forty-eight adult female Sprague-Dawley rats were randomly divided into two treatment groups. The implant of interest-either seeded or not with rMSCs-was laid and fixed over the muscular abdominal wall. Main outcome measures were: in vitro, proliferation of rMSCs on selected materials; in vivo, the occurrence of topical complications, the evaluation of systemic and local inflammatory response and examination of the biomechanical properties of explants. RESULTS: Surgisis and Pelvitex displayed the best cell growth in vitro. At 90 days in the rat model, rMSCs were related to a lower count of neutrophil cells for Pelvitex and a greater organisation and collagen amount for Surgisis. At 7 days Surgisis samples seeded with rMSCs displayed higher breaking force and stiffness. CONCLUSIONS: The presence of rMSCs reduced the systemic inflammatory response on synthetic implants and improved collagen characteristics at the interface between biological grafts and native tissues. rMSCs enhanced the stripping force on biological explants.

Wrist-ankle acupuncture as perineal pain relief after mediolateral episiotomy: a pilot study.

OBJECTIVES: The purpose of this pilot study was to evaluate the efficacy of acupuncture in relieving perineal pain after mediolateral episiotomy during childbirth. DESIGN AND SUBJECTS: Women with mediolateral episiotomy during delivery were enrolled in this study and were assigned to be treated or not with acupuncture. OUTCOMES MEASURES: Perineal pain relieving effect of acupuncture was evaluated considering oral analgesics request during post-partum period and was the main outcome of this trial. RESULTS: A total of 42 women were enrolled in this trial. Twenty-one (21) women were treated with "wrist-ankle" acupuncture, inserting one needle in their right ankle. A second group of 21 women was not treated with acupuncture. Women in the acupuncture group were significantly less likely to experience pain; only 8 of them (38.1%) asked for analgesics. All women in the second group assumed oral analgesics because of perineal pain (p < 0.01). CONCLUSIONS: Wrist-ankle acupuncture during the postpartum period is effective for perineal pain relief after mediolateral episiotomy.