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Surgical Endoscopy
Published in: Surgical Endoscopy 4/2017

01-04-2017

Doxycycline alters collagen composition following ventral hernia repair

Authors: Job C. Tharappel, Jennifer W. Harris, Crystal Totten, Brittany A. Zwischenberger, John S. Roth

Published in: Surgical Endoscopy | Issue 4/2017

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Abstract

Background

Doxycycline, a nonspecific metalloproteinase (MMP) inhibitor, has been demonstrated to impact the strength of the polypropylene (PP) mesh-repaired hernia with an increase in the deposition of collagen type 1. The impact of doxycycline with porcine acellular dermal matrices (PADM) is unknown; therefore, we evaluated the impact of doxycycline administration upon hernia repair with PP and PADM mesh.

Methods

Sprague–Dawley rats weighing ~400 g underwent laparotomy with creation of a midline ventral hernia. After a 27-day recovery, animals were randomly assigned to four groups of eight and underwent intraperitoneal underlay hernia repair with either PP or PADM. Groups were assigned to daily normal saline (S) or daily doxycycline in normal saline 10 mg/kg (D) via oral gavage for 8 weeks beginning 24 h preoperatively. Animals were euthanized at 8 weeks and underwent tensiometric testing of the abdominal wall and western blot analyses for collagen subtypes and MMPs.

Results

Thirty-two animals underwent successful hernia creation and repair with either PADM or PP. At 8 weeks, 15 of 16 PP-implanted animals survived with only 12 of 16 PADM-implanted animals surviving. There were no differences in the mesh to fascial interface tensiometric strength between groups. Densitometric counts in the PADM-D group demonstrated increased collagen type 1 compared to PP-S (PADM-D [1286.5], PADM-S [906.9], PP-S [700.4], p = 0.037) and decreased collagen type 3 compared to PP-S (PADM-D [7446.9], PADM-S [8507.6], PP-S [11,297.1], p = 0.01). MMP-9 levels were increased in PADM-D (PP-S vs. PADM-D, p = 0.04), while MMP-2 levels were similar between PADM-D and PADM-S, respectively.

Conclusions

Collagen type 1 deposition at the mesh to fascial interface is enhanced following administration of doxycycline in ventral hernia repairs with porcine acellular dermal matrices. Doxycycline administration may have implications for enhancing hernia repair outcomes using biologic mesh.
Literature
1.
Israelsson LA, Jonsson T (1996) Incisional hernia after midline laparotomy: a prospective study. Eur J Surg 162:125–129PubMed
2.
Read RC, Yoder G (1989) Recent trends in the management of incisional herniation. Arch Surg 124:485–488CrossRefPubMed
3.
Ditzel M, Deerenberg EB, Grotenhuis N, Harlaar JJ, Monkhorst K, Bastiaansen-Jenniskens YM, Jeekel J, Lange JF (2013) Biologic meshes are not superior to synthetic meshes in ventral hernia repair: an experimental study with long-term follow-up evaluation. Surg Endosc 27:3654–3662CrossRefPubMed
4.
5.
6.
Regnard JF, Hay JM, Rea S, Fingerhut A, Flamant Y, Maillard JN (1988) Ventral incisional hernias: incidence, date of recurrence, localization and risk factors. Ital J Surg Sci 18:259–265PubMed
7.
Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72:70–71CrossRefPubMed
8.
Urschel JD, Scott PG, Williams HT (1988) Etiology of late developing incisional hernias—the possible role of mechanical stress. Med Hypotheses 25:31–34CrossRefPubMed
9.
Cengiz U, Israelsson LA (1998) Incisional hernias in midline incisions: an eight-year follow up. Hernia 2:175–177CrossRef
10.
11.
Sugerman HJ, Kellum JM Jr, Reines HD, DeMaria EJ, Newsome HH, Lowry JW (1996) Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 171:80–84CrossRefPubMed
12.
Hesselink VJ, Luijendijk RW, DeWitt JH, Heide R, Jeekel J (1993) An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet 3:228–235
13.
Lamont PM, Ellis H (1988) Incisional hernia in re-opened abdominal incisions: an overlooked risk factor. Br J Surg 75:374–376CrossRefPubMed
14.
Rutkow IM (1998) Epidemiologic, economic and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin North Am 78:941–951CrossRefPubMed
15.
George CD, Ellis H (1986) The results of incisional hernia repair: a twelve year review. Ann R Coll Surg Engl 68:185–187PubMedPubMedCentral
16.
Langer S, Christiansen J (1985) Long-term results after incisional hernia repair. Acta Chir Scand 151:217–219PubMed
17.
Anthony T, Bergen PC, Kim LT, Henderson M, Fahey T, Rege RV, Turnage RH (2000) Factors affecting recurrence following incisional herniorrhaphy. World J Surg 24:95–101CrossRefPubMed
18.
Leber GE, Garb JL, Alexander AJ, Reed WP (1998) Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 133:378–382CrossRefPubMed
19.
20.
Salameh JR, Talbott LM, May W, Gosheh B, Vig PJ, McDaniel DO (2007) Role of biomarkers in incisional hernias. Am Surg 73:561–568PubMed
21.
22.
Mignatti P, Rifkin DB, Welgus HG, Parks WC (1996) Proteinases and tissue remodeling. In: Clark RAF (ed) The molecular and cellular biology of wound repair, 2nd edn. Plenum, New York, pp 427–474
23.
Wilcox JR, Covington DS, Paez N (2012) Doxycycline as a modulator of inflammation in chronic wounds. Wounds 24:339–349PubMed
24.
Antoniou SA, Antoniou GA, Granderath FA, Simopoulos C (2009) The role of matrix metalloproteinases in the pathogenesis of abdominal wall hernias. Eur J Clin Invest 39:953–959CrossRefPubMed
25.
Tharappel JC, Bower CE, Whittington-Harris J, Ramineni SK, Puleo DA, Roth JS (2014) Doxycycline administration improves fascial interface in hernia repair. J Surg Res 190:692–698CrossRefPubMed
26.
Tharappel JC, Ramineni SK, Reynolds D, Puleo DA, Roth JS (2013) Doxycycline impacts hernia repair outcomes. J Surg Res 184:699–704CrossRefPubMed
27.
Tharappel JC, Harris JW, Zwischenberger BA, Levy Salomon M, Puleo DA, Roth JS (2015) Doxycycline shows dose-dependent changes in hernia repair strength after mesh repair. Sur Endosc 30:2016–2021CrossRef
28.
Rice RD, Ayubi FS, Shaub ZJ, Parker DM, Armstrong PJ, Tsai JW (2010) Comparison of Surgisis, AlloDerm, and Vicryl woven mesh grafts for abdominal wall defect repair in an animal model. Aesth Plast Surg 34:290–296CrossRef
29.
Badylak SF (2014) Decellularized allogeneic and xenogeneic tissue as a bioscaffold for regenerative medicine: factors that influence the host response. Ann Biomed Eng 42:1517–1527CrossRefPubMed
30.
31.
Pui CL, Tang ME, Annor AH, Ebersole GC, Frisella MM, Matthews BD, Deeken CR (2012) Effects of repetitive loading on the mechanical properties of biologic scaffold materials. J Am Coll Surg 215:216–228CrossRefPubMed
32.
Gaertner WB, Bonsack ME, Delaney JP (2007) Experimental evaluation of four biologic prostheses for ventral hernia repair. J Gastrointest Surg 11:1275–1285CrossRefPubMed
33.
Reynolds D, Davenport DL, Korosec RL, Roth JS (2013) Financial implications of ventral hernia repair: a hospital cost analysis. J Gastrointest Surg 17:159–166 (discussion 166-167) CrossRefPubMed
34.
Totten CF, Davenport DL, Ward ND, Roth JS (2016) Cost of ventral hernia repair using biologic or synthetic mesh. J Surg Res 203:459–465CrossRefPubMed
35.
Bondre IL, Holihan JL, Askenasy EP, Greenberg JA, Keith JN, Martindale RG, Roth JS, Liang MK, Ventral Hernia Outcomes Collaborative (2016) Suture, synthetic, or biologic in contaminated ventral hernia repair. J Surg Res 200:488–494CrossRefPubMed
36.
Carbonell AM, Criss CN, Cobb WS, Novitsky YW, Rosen MJ (2013) Outcomes of synthetic mesh in contaminated ventral hernia repairs. J Am Coll Surg 217:991–998CrossRefPubMed
Metadata
Title
Doxycycline alters collagen composition following ventral hernia repair
Authors
Job C. Tharappel
Jennifer W. Harris
Crystal Totten
Brittany A. Zwischenberger
John S. Roth
Publication date
01-04-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 4/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5155-8

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