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Published in: International Urogynecology Journal 10/2013

01-10-2013 | Original Article

Highly purified collagen coating enhances tissue adherence and integration properties of monofilament polypropylene meshes

Authors: Rodrigo Teixeira Siniscalchi, Marli Melo, Paulo César Rodrigues Palma, Inácio Maria Dal Fabbro, Benedicto de Campos Vidal, Cassio Luiz Zanettini Riccetto

Published in: International Urogynecology Journal | Issue 10/2013

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Abstract

Introduction and hypothesis

Complications related to tissue integration of polypropylene implants used in the treatment of pelvic organ prolapse are relatively prevalent. Collagen, a biocompatible, less immunogenic material with modulating properties on the inflammatory process, may improve polypropylene integration. The objective was to study biomechanical and histological effects of monofilament polypropylene mesh coated with purified collagen gel.

Methods

Forty rats were implanted with two fragments of polypropylene mesh in their abdominal walls (one on each side of the linea alba). One of the fragments had a collagen gel coating (group I) while the other one did not (group II). The animals were euthanized at 7, 14, 90, and 180 days after implantation and their abdominal walls were excised for analysis.

Results

The biomechanical study showed that mesh adherence to neighboring tissue increased significantly in group II (p < 0.05). Acute (p < 0.001) and chronic (p = 0.004) inflammatory responses as well as granulation tissue formation (p = 0.001) were less intense in group II at 7 and 14 days. Granulomatous inflammation and foreign body reaction was less significant at 7 days in group II (p = 0.029 and p < 0.001). The birefringence analysis showed higher mean brightness density in the late phase of implantation in group II meshes (p = 0.000).

Conclusion

Polypropylene mesh coated with purified collagen gel increases adherence to tissue, promotes a less intense and lasting inflammatory response and triggers a greater organization and packing arrangement of collagen fibers in the late phase of implantation.
Literature
1.
go back to reference Chen HY, Chung YW, Lin WY, Wang JC, Tsai FJ, Tsai CH (2008) Collagen type 3 alpha 1 polymorphism and risk of pelvic organ prolapse. Int J Gynaecol Obstet 103:55–58PubMedCrossRef Chen HY, Chung YW, Lin WY, Wang JC, Tsai FJ, Tsai CH (2008) Collagen type 3 alpha 1 polymorphism and risk of pelvic organ prolapse. Int J Gynaecol Obstet 103:55–58PubMedCrossRef
2.
go back to reference De Ridder D (2008) Should we use meshes in the management of vaginal prolapse? Curr Opin Urol 18(4):377–382PubMedCrossRef De Ridder D (2008) Should we use meshes in the management of vaginal prolapse? Curr Opin Urol 18(4):377–382PubMedCrossRef
3.
go back to reference Shepherd JP, Feola AJ, Abramowitch SD, Moalli PA (2012) Uniaxial biomechanical properties of seven different vaginally implanted meshes for pelvic organ prolapse. Int Urogynecol J 23:613–620PubMedCrossRef Shepherd JP, Feola AJ, Abramowitch SD, Moalli PA (2012) Uniaxial biomechanical properties of seven different vaginally implanted meshes for pelvic organ prolapse. Int Urogynecol J 23:613–620PubMedCrossRef
4.
go back to reference Patel H, Ostergard DR, Sternschuss G (2012) Polypropylene mesh and the host response. Int Urogynecol J 23:669–679PubMedCrossRef Patel H, Ostergard DR, Sternschuss G (2012) Polypropylene mesh and the host response. Int Urogynecol J 23:669–679PubMedCrossRef
5.
go back to reference Guerrete N, Peterson TV, Aguirre OA, VanDrie DM, Biller DH, Davila GW (2009) Anterior repair with or without collagen matrix reinforcement. A randomized controlled trial. Obstet Gynecol 114(1):59–65 Guerrete N, Peterson TV, Aguirre OA, VanDrie DM, Biller DH, Davila GW (2009) Anterior repair with or without collagen matrix reinforcement. A randomized controlled trial. Obstet Gynecol 114(1):59–65
6.
go back to reference Huffaker RK, Muir TW, Rao A et al (2008) Histologic response of porcine collagen-coated and uncoated polypropylene grafts in a rabbit vaginal model. Am J Obstet Gynecol 198(582):1–7 Huffaker RK, Muir TW, Rao A et al (2008) Histologic response of porcine collagen-coated and uncoated polypropylene grafts in a rabbit vaginal model. Am J Obstet Gynecol 198(582):1–7
7.
go back to reference De Tayrac R, Alves A, Thérin M (2007) Collagen-coated vs noncoated low-weight polypropylene meshes in a sheep model for vaginal surgery. A pilot study. Int Urogynecol J Pelvic Floor Dysfunct 18(5):513–520PubMedCrossRef De Tayrac R, Alves A, Thérin M (2007) Collagen-coated vs noncoated low-weight polypropylene meshes in a sheep model for vaginal surgery. A pilot study. Int Urogynecol J Pelvic Floor Dysfunct 18(5):513–520PubMedCrossRef
8.
go back to reference Kuiper N, Gabriel N, Griffiths S, Tew S (2008) Shaping and sensing the extracellular matrix. Int J Exp Pathol 89:A1–A29CrossRef Kuiper N, Gabriel N, Griffiths S, Tew S (2008) Shaping and sensing the extracellular matrix. Int J Exp Pathol 89:A1–A29CrossRef
9.
go back to reference Maturana LG, Zanon RG, Pierucci A, Vidal BC, Oliveira AL (2011) Supraorganized collagen enhances Schwann cell reactivity and organization in vitro. Braz J Med Biol Res 44(7):682–687PubMed Maturana LG, Zanon RG, Pierucci A, Vidal BC, Oliveira AL (2011) Supraorganized collagen enhances Schwann cell reactivity and organization in vitro. Braz J Med Biol Res 44(7):682–687PubMed
10.
go back to reference De Vidal BC (1995) From collagen type I solution to fibers with a helical pattern: a self-assembly phenomenon. C R Acad Sci III 318(8):831–836 De Vidal BC (1995) From collagen type I solution to fibers with a helical pattern: a self-assembly phenomenon. C R Acad Sci III 318(8):831–836
11.
go back to reference Vidal BC (2003) Image analysis of tendon helical superstructure using interference and polarized light microscopy. Micron 34:423–432CrossRef Vidal BC (2003) Image analysis of tendon helical superstructure using interference and polarized light microscopy. Micron 34:423–432CrossRef
12.
go back to reference Vidal BC (2010) Form birefringence as applied to biopolymer and inorganic material supraorganization. Biotech Histochem 85(6):365–378PubMedCrossRef Vidal BC (2010) Form birefringence as applied to biopolymer and inorganic material supraorganization. Biotech Histochem 85(6):365–378PubMedCrossRef
13.
go back to reference Chvapil M, Kronenthal RL, Van Winkle W Jr (1973) Medical and surgical application of collagen. Int Rev Conn Tissue Res 6:1–15 Chvapil M, Kronenthal RL, Van Winkle W Jr (1973) Medical and surgical application of collagen. Int Rev Conn Tissue Res 6:1–15
14.
go back to reference Siniscalchi R, Palma P, Riccetto C, Maciel LC, Ens G, del Fabbro I (2011) Biomechanical effects of the inclusion of holes to facilitate the integration in monofilament polypropylene meshes: an experimental study. Actas Urol Esp 35(10):599–604PubMedCrossRef Siniscalchi R, Palma P, Riccetto C, Maciel LC, Ens G, del Fabbro I (2011) Biomechanical effects of the inclusion of holes to facilitate the integration in monofilament polypropylene meshes: an experimental study. Actas Urol Esp 35(10):599–604PubMedCrossRef
15.
go back to reference Paulo P, Siniscalchi RT, Maciel LC, Bigozzi MA, Dal Fabbro IM, Riccetto CLZ (2012) Primary fixation of mini slings: a comparative biomechanical study in vivo. Int Braz J Urol 38:258–266CrossRef Paulo P, Siniscalchi RT, Maciel LC, Bigozzi MA, Dal Fabbro IM, Riccetto CLZ (2012) Primary fixation of mini slings: a comparative biomechanical study in vivo. Int Braz J Urol 38:258–266CrossRef
16.
go back to reference Riccetto C, Miyaoka R, de Fraga R, Barbosa R, Dambros M, Teixeira A, Palma P (2008) Impact of the structure of polypropylene meshes in local tissue reaction: in vivo stereological study. Int Urogynecol J Pelvic Floor Dysfunct 19(8):1117–1123PubMedCrossRef Riccetto C, Miyaoka R, de Fraga R, Barbosa R, Dambros M, Teixeira A, Palma P (2008) Impact of the structure of polypropylene meshes in local tissue reaction: in vivo stereological study. Int Urogynecol J Pelvic Floor Dysfunct 19(8):1117–1123PubMedCrossRef
17.
go back to reference Vidal BC, Mello ML (2010) Optical anisotropy of collagen fibers of rat calcaneal tendons: Na approach to spatially resolved supramolecular organization. Acta Histochem 112:53–56CrossRef Vidal BC, Mello ML (2010) Optical anisotropy of collagen fibers of rat calcaneal tendons: Na approach to spatially resolved supramolecular organization. Acta Histochem 112:53–56CrossRef
18.
go back to reference Vidal BC (1986) Evaluation of the carbohydrate role in the molecular order of collagen bundles: microphotometric measurements of textural birefringence. Cell Mol Biol 32(5):527–535 Vidal BC (1986) Evaluation of the carbohydrate role in the molecular order of collagen bundles: microphotometric measurements of textural birefringence. Cell Mol Biol 32(5):527–535
19.
go back to reference Krause HG, Galloway SJ, Khoo SK, Lourie R, Goh JTW (2006) Biocompatible properties of surgical mesh using an animal model. Aust N Z J Obstet Gynaecol 46:42–45PubMedCrossRef Krause HG, Galloway SJ, Khoo SK, Lourie R, Goh JTW (2006) Biocompatible properties of surgical mesh using an animal model. Aust N Z J Obstet Gynaecol 46:42–45PubMedCrossRef
20.
go back to reference Bogusiewicz M, Wrobel A, Jankiewicz K, Adamiak A, Skorupski P, Tomaszewski J, Rechberger T (2006) Collagen deposition around polypropylene tapes implanted in the rectus fascia of female rats. Eur J Obstet Gynecol Reprod Biol 124:106–109PubMedCrossRef Bogusiewicz M, Wrobel A, Jankiewicz K, Adamiak A, Skorupski P, Tomaszewski J, Rechberger T (2006) Collagen deposition around polypropylene tapes implanted in the rectus fascia of female rats. Eur J Obstet Gynecol Reprod Biol 124:106–109PubMedCrossRef
21.
go back to reference Thiel M, Palma PCR, Riccetto CLZ, Dambros M, Netto NR Jr (2005) A stereological analysis of fibrosis and inflammatory reaction induced by four different synthetic slings. BJU Int 95:833–837PubMedCrossRef Thiel M, Palma PCR, Riccetto CLZ, Dambros M, Netto NR Jr (2005) A stereological analysis of fibrosis and inflammatory reaction induced by four different synthetic slings. BJU Int 95:833–837PubMedCrossRef
22.
go back to reference Afonso JS, Martins PALS, Girão MJB, Natal Jorge RM, Ferreira AJ, Mascarenhas T, Fernandes AA, Bernardes J, Baracat EC, Rodrigues de Lima G, Patrício B (2008) Mechanical properties of polypropylene mesh used in pelvic floor repair. Int Urogynecol J Pelvic Floor Dysfunct 19(3):375–380PubMedCrossRef Afonso JS, Martins PALS, Girão MJB, Natal Jorge RM, Ferreira AJ, Mascarenhas T, Fernandes AA, Bernardes J, Baracat EC, Rodrigues de Lima G, Patrício B (2008) Mechanical properties of polypropylene mesh used in pelvic floor repair. Int Urogynecol J Pelvic Floor Dysfunct 19(3):375–380PubMedCrossRef
23.
go back to reference Bazi TM, Hamade RF, Hussein IAH, Nader KA, Jurjus A (2007) Polypropylene midurethral tapes do not have similar biologic and biomechanical performance in the rat. Eur Urol 51:1364–1375PubMedCrossRef Bazi TM, Hamade RF, Hussein IAH, Nader KA, Jurjus A (2007) Polypropylene midurethral tapes do not have similar biologic and biomechanical performance in the rat. Eur Urol 51:1364–1375PubMedCrossRef
24.
go back to reference Zheng F, Lin Y, Verbeken E, Claerhout F, Fastrez M, De Ridder D, Deprest J (2004) Host response after reconstruction of abdominal wall defects with porcine dermal collagen in a rat model. Am J Obstet Gynecol 191(6):1961–1970PubMedCrossRef Zheng F, Lin Y, Verbeken E, Claerhout F, Fastrez M, De Ridder D, Deprest J (2004) Host response after reconstruction of abdominal wall defects with porcine dermal collagen in a rat model. Am J Obstet Gynecol 191(6):1961–1970PubMedCrossRef
25.
go back to reference Claerhout F, Verbist G, Verbeken E, Konstantinovic M, De Ridder D, Deprest J (2008) Fate of collagen-based implants used in pelvic floor surgery: a 2-year follow-up study in a rabbit model. Am J Obstet Gynecol 198(1):94.e1–94.e6. doi:10.1016/j.ajog.2007.05.032 CrossRef Claerhout F, Verbist G, Verbeken E, Konstantinovic M, De Ridder D, Deprest J (2008) Fate of collagen-based implants used in pelvic floor surgery: a 2-year follow-up study in a rabbit model. Am J Obstet Gynecol 198(1):94.e1–94.e6. doi:10.​1016/​j.​ajog.​2007.​05.​032 CrossRef
26.
go back to reference Cervigni M, Natale F, La Penna C, Saltari M, Padoa A, Agostini M (2011) Collagen-coated polypropylene mesh in vaginal prolapse surgery: an observational study. Eur J Obstet Gynecol Reprod Biol 156(2):223–227PubMedCrossRef Cervigni M, Natale F, La Penna C, Saltari M, Padoa A, Agostini M (2011) Collagen-coated polypropylene mesh in vaginal prolapse surgery: an observational study. Eur J Obstet Gynecol Reprod Biol 156(2):223–227PubMedCrossRef
27.
go back to reference Van’t Riet M, Burger JM, Bonthuis F, Jeekel J, Bonjer HJ (2004) Prevention of adhesion formation to polypropylene mesh by collagen coating: a randomized controlled study in a rat model of ventral hernia repair. Surg Endosc 18:681–685CrossRef Van’t Riet M, Burger JM, Bonthuis F, Jeekel J, Bonjer HJ (2004) Prevention of adhesion formation to polypropylene mesh by collagen coating: a randomized controlled study in a rat model of ventral hernia repair. Surg Endosc 18:681–685CrossRef
28.
go back to reference Provenzano PP, Vanderby R (2006) Collagen fibril morphology and organization: implications for force transmission in ligament and tendon. Matrix Biol 25:71–84PubMedCrossRef Provenzano PP, Vanderby R (2006) Collagen fibril morphology and organization: implications for force transmission in ligament and tendon. Matrix Biol 25:71–84PubMedCrossRef
Metadata
Title
Highly purified collagen coating enhances tissue adherence and integration properties of monofilament polypropylene meshes
Authors
Rodrigo Teixeira Siniscalchi
Marli Melo
Paulo César Rodrigues Palma
Inácio Maria Dal Fabbro
Benedicto de Campos Vidal
Cassio Luiz Zanettini Riccetto
Publication date
01-10-2013
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 10/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-013-2109-8

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