Fetoscopic coverage of experimental myelomeningocele in sheep using a patch with surgical sealant.

OBJECTIVE: Assess the feasibility of a fetoscopic patch coverage method for myelomeningocele repair in a sheep model. STUDY DESIGN: Experimental study. A myelomeningocele-like defect was created in 15 fetal sheep on day 75 of gestation. Six remained untreated, whereas 9 underwent fetoscopic coverage of the defect on day 95 of gestation using an inert patch secured with surgical sealant. Clinical and histological examinations were performed after delivery. RESULTS: Four valid newborn lambs were obtained in each group. Mean fetoscopic surgical time was 26.9 (SD=7.4)min. All untreated animals had an open lumbar defect with cerebrospinal fluid leakage, paraplegia, urinary incontinence, and Chiari malformation. All treated animals had a closed defect and were able to walk; one had weak bladder control, and another mild Chiari malformation. CONCLUSION: In a chronic myelomeningocele model in fetal sheep, fetoscopic repair using a sealed patch results in simple, fast, satisfactory neural tube closure and averts neurological damage and Chiari malformation.

Effects of platelet-rich plasma on intestinal wound healing in pigs.

Anastomotic dehiscence and leakage remain a major problem in gastrointestinal surgery. Recently, attention has been focused on cellular acceleration of the wound healing process using platelet-rich plasma (PRP) and this study reports the effects of PRP on intestinal wound healing in pigs. Autologous PRP was obtained from 35 pigs that were then subjected to two intestinal anastomosis procedures. Activated PRP was applied at one of the anastomosis sites, while the other site served as control. After 24, 48, 72 and 96 h and then at 7 days, histology was performed and wound breaking strength was measured at 72 h and 7 days. PRP application appeared to increase granulation tissue and fibrosis, but did not influence anastomotic breaking strength.