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Evaluation of a biodegradable polyurethane patch for repair of diaphragmatic hernia in a rat model: A pilot study.
Theodorou, Christina M; Taylor, Alan; Lee, Su Yeon; Cortez, Lia Molina; Fu, Huikang; Pivetti, Christopher D; Zhang, Chaoxing; Stasyuk, Anastasiya; Hao, Dake; Kumar, Priyadarsini; Farmer, Diana L; Liao, Jun; Brown, Erin G; Hong, Yi; Wang, Aijun.
Affiliation
  • Theodorou CM; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA.
  • Taylor A; Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, TX 76019, USA.
  • Lee SY; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA.
  • Cortez LM; Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, TX 76019, USA.
  • Fu H; Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, TX 76019, USA.
  • Pivetti CD; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA; Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, 2425 Stockton Blvd, Sacramento, CA, 95817, USA.
  • Zhang C; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA; Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, 2425 Stockton Blvd, Sacramento, CA, 95817, USA.
  • Stasyuk A; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA.
  • Hao D; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA; Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, 2425 Stockton Blvd, Sacramento, CA, 95817, USA.
  • Kumar P; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA; Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, 2425 Stockton Blvd, Sacramento, CA, 95817, USA.
  • Farmer DL; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA; Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, 2425 Stockton Blvd, Sacramento, CA, 95817, USA.
  • Liao J; Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, TX 76019, USA.
  • Brown EG; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA.
  • Hong Y; Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, Arlington, TX 76019, USA. Electronic address: yihong@uta.edu.
  • Wang A; Center for Surgical Bioengineering, Department of Surgery, School of Medicine, University of California Davis, 4625 2nd Avenue, Room 3001, Sacramento, CA, 95817, USA; Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, 2425 Stockton Blvd, Sacramento, CA, 95817, USA; Depar
J Pediatr Surg ; 58(5): 964-970, 2023 May.
Article in En | MEDLINE | ID: mdl-36797111
ABSTRACT

INTRODUCTION:

Congenital diaphragmatic hernia (CDH) repair is an area of active research. Large defects requiring patches have a hernia recurrence rate of up to 50%. We designed a biodegradable polyurethane (PU)-based elastic patch that matches the mechanical properties of native diaphragm muscle. We compared the PU patch to a non-biodegradable Gore-Tex™ (polytetrafluoroethylene) patch.

METHODS:

The biodegradable polyurethane was synthesized from polycaprolactone, hexadiisocyanate and putrescine, and then processed into fibrous PU patches by electrospinning. Rats underwent 4 mm diaphragmatic hernia (DH) creation via laparotomy followed by immediate repair with Gore-Tex™ (n = 6) or PU (n = 6) patches. Six rats underwent sham laparotomy without DH creation/repair. Diaphragm function was evaluated by fluoroscopy at 1 and 4 weeks. At 4 weeks, animals underwent gross inspection for recurrence and histologic evaluation for inflammatory reaction to the patch materials.

RESULTS:

There were no hernia recurrences in either cohort. Gore-Tex™ had limited diaphragm rise compared to sham at 4 weeks (1.3 mm vs 2.9 mm, p = 0.003), but no difference was found between PU and sham (1.7 mm vs 2.9 mm, p = 0.09). There were no differences between PU and Gore-Tex™ at any time point. Both patches formed an inflammatory capsule, with similar thicknesses between cohorts on the abdominal (Gore-Tex™ 0.07 mm vs. PU 0.13 mm, p = 0.39) and thoracic (Gore-Tex™ 0.3 mm vs. PU 0.6 mm, p = 0.09) sides.

CONCLUSION:

The biodegradable PU patch allowed for similar diaphragmatic excursion compared to control animals. There were similar inflammatory responses to both patches. Further work is needed to evaluate long-term functional outcomes and further optimize the properties of the novel PU patch in vitro and in vivo. LEVEL OF EVIDENCE Level II, Prospective Comparative Study.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Hernias, Diaphragmatic, Congenital Type of study: Observational_studies Limits: Animals Language: En Journal: J Pediatr Surg Year: 2023 Document type: Article Affiliation country: United States
Fulltext
Add to My VHL
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Hernias, Diaphragmatic, Congenital Type of study: Observational_studies Limits: Animals Language: En Journal: J Pediatr Surg Year: 2023 Document type: Article Affiliation country: United States