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01-12-2018 | Original Article

Sirolimus-coated, poly(l-lactic acid)-modified polypropylene mesh with minimal intra-peritoneal adhesion formation in a rat model

Authors: S. Lu, W. Hu, Z. Zhang, Z. Ji, T. Zhang

Published in: Hernia | Issue 6/2018

Abstract

Purpose

This study evaluated the manufacturing method and anti-adhesion properties of a new composite mesh in the rat model, which was made from sirolimus (SRL) grafts on a poly(l-lactic acid) (PLLA)-modified polypropylene (PP) hernia mesh.

Methods

PLLA was first grafted onto argon-plasma-treated native PP mesh through catalysis of stannous chloride. SRL was grafted onto the surface of PP-PLLA meshes using catalysis of 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC) and 4-dimethylaminopyridine (DMAP) in a CH₂Cl₂ solvent. Sprague–Dawley female rats received either SRL-coated meshes, PP-PLLA meshes, or native PP meshes to repair abdominal wall defects. At different intervals, rats were euthanized by a lethal dose of chloral hydrate and adhesion area and tenacity were evaluated. Sections of the mesh with adjacent tissues were assessed histologically.

Results

Attenuated total reflection Fourier transformed infrared (ATR-FTIR) spectroscopy indicated the existence of a C=O group absorption peak (1724.1 cm⁻¹), and scanning electron microscope morphological analysis indicated that the surface of the PP mesh was covered with SRL. Compared to the native PP meshes and PP-PLLA meshes, SRL-coated meshes demonstrated the greatest ability to decrease the formation of adhesions (P < 0.05) and inflammation.

Conclusions

The SRL-coated composite mesh showed minimal formation of intra-abdominal adhesions in a rat model of abdominal wall defect repair.

Bosanquet DC, Ansell J, Abdelrahman T, Cornish J, Harries R, Stimpson A, Davies L, Glasbey JC, Frewer KA, Frewer NC, Russell D, Russell I, Torkington J (2015) Systematic review and meta-regression of factors affecting midline incisional hernia rates: analysis of 14,618 patients. PLoS One 10(9):e0138745. https://doi.org/10.1371/journal.pone.0138745 PubMedPubMedCentralCrossRef

Zinther NB, Wara P, Friis-Andersen H (2010) Intraperitoneal onlay mesh: an experimental study of adhesion formation in a sheep model. Hernia J Hernias Abdom Wall Surg 14(3):283–289. https://doi.org/10.1007/s10029-009-0622-y CrossRef

Jamry A, Jalynski M, Piskorz L, Brocki M (2013) Assessment of adhesion formation after laparoscopic intraperitoneal implantation of Dynamesh IPOM mesh. Arch Med Sci AMS 9(3):487–492. https://doi.org/10.5114/aoms.2013.35345 PubMedCrossRef

Muysoms FE, Bontinck J, Pletinckx P (2011) Complications of mesh devices for intraperitoneal umbilical hernia repair: a word of caution. Hernia J Hernias Abdom Wall Surg 15(4):463–468. https://doi.org/10.1007/s10029-010-0692-x CrossRef

Shankaran V, Weber DJ, Reed RL 2nd, Luchette FA (2011) A review of available prosthetics for ventral hernia repair. Ann Surg 253(1):16–26. https://doi.org/10.1097/SLA.0b013e3181f9b6e6 PubMedCrossRef

Anderson JM, Rodriguez A, Chang DT (2008) Foreign body reaction to biomaterials. Semin Immunol 20(2):86–100. https://doi.org/10.1016/j.smim.2007.11.004 PubMedCrossRef

Poppas DP, Sung JJ, Magro CM, Chen J, Toyohara JP, Ramshaw BJ, Felsen D (2016) Hydrogel coated mesh decreases tissue reaction resulting from polypropylene mesh implant: implication in hernia repair. Hernia J Hernias Abdom Wall Surg 20(4):623–632. https://doi.org/10.1007/s10029-016-1481-y CrossRef

Deeken CR, Faucher KM, Matthews BD (2012) A review of the composition, characteristics, and effectiveness of barrier mesh prostheses utilized for laparoscopic ventral hernia repair. Surg Endosc 26(2):566–575. https://doi.org/10.1007/s00464-011-1899-3 PubMedCrossRef

Practice Committee of the American Society for Reproductive Medicine (2006) Control and prevention of peritoneal adhesions in gynecologic surgery. Fertil Steril 86(5 Suppl 1):S1–S5. https://doi.org/10.1016/j.fertnstert.2006.07.1483 CrossRef

10.

Langer JC, Liebman SM, Monk PK, Pelletier GJ (1995) Mast cell mediators and peritoneal adhesion formation in the rat. J Surg Res 59(3):344–348. https://doi.org/10.1006/jsre.1995.1174 PubMedCrossRef

11.

Li L, Zheng X, Fan D, Yu S, Wu D, Fan C, Cui W, Ruan H (2016) Release of celecoxib from a bi-layer biomimetic tendon sheath to prevent tissue adhesion. Mater Sci Eng C Mater Biol Appl 61:220–226. https://doi.org/10.1016/j.msec.2015.12.028 PubMedCrossRef

12.

Chisari A, Pistritto AM, Piccolo R, La Manna A, Danzi GB (2016) The ultimaster biodegradable-polymer sirolimus-eluting stent: an updated review of clinical evidence. Int J Mol Sci 17(9):1490. https://doi.org/10.3390/ijms17091490 PubMedCentralCrossRef

13.

Motse KG, Mashabane MJ (2016) Sirolimus-induced lymphoedema. S Afr Med J Suid-Afrikaanse tydskrif vir geneeskunde 106(9):886–887. https://doi.org/10.7196/SAMJ.2016.v106i9.10636 PubMedCrossRef

14.

Zhang Z, Zhang T, Li J, Ji Z, Zhou H, Zhou X, Gu N (2014) Preparation of poly(l-lactic acid)-modified polypropylene mesh and its antiadhesion in experimental abdominal wall defect repair. J Biomed Mater Res Part B Appl Biomater 102(1):12–21PubMedCrossRef

15.

Maciver AH, McCall MD, Edgar RL, Thiesen AL, Bigam DL, Churchill TA, Shapiro AM (2011) Sirolimus drug-eluting, hydrogel-impregnated polypropylene mesh reduces intra-abdominal adhesion formation in a mouse model. Surgery 150(5):907–915. https://doi.org/10.1016/j.surg.2011.06.022 PubMedCrossRef

16.

Gomathi N, Neogi S (2013) Surface modification of polypropylene using argon plasma: statistical optimization of the process variables. Appl Surf Sci 51(6):1273–1278

17.

Jayanth ST, Pulimood A, Abraham D, Rajaram A, Paul MJ, Nair A (2015) A randomized controlled experimental study comparing chitosan coated polypropylene mesh and proceed mesh for abdominal wall defect closure. Ann Med Surg 4(4):388–394. https://doi.org/10.1016/j.amsu.2015.10.002 CrossRef

18.

Zhang L (2015) Incidence of abdominal incisional hernia in developing country: a retrospective cohort study. Int J Clin Exp Med 8(8):13649–13652PubMedPubMedCentral

19.

Usher FC, Ochsner J, Tuttle LL Jr (1958) Use of marlex mesh in the repair of incisional hernias. Am Surg 24(12):969–974PubMed

20.

Vorst AL, Kaoutzanis C, Carbonell AM, Franz MG (2015) Evolution and advances in laparoscopic ventral and incisional hernia repair. World J Gastrointest Surg 7(11):293–305. https://doi.org/10.4240/wjgs.v7.i11.293 PubMedPubMedCentralCrossRef

21.

Rastegarpour A, Cheung M, Vardhan M, Ibrahim MM, Butler CE, Levinson H (2016) Surgical mesh for ventral incisional hernia repairs: understanding mesh design. Plast Surg (Oakville, Ont) 24(1):41–50CrossRef

22.

Turza KC, Butler CE (2012) Adhesions and meshes: synthetic versus bioprosthetic. Plast Reconstr Surg 130(5 Suppl 2):206S–213S. https://doi.org/10.1097/PRS.0b013e3182638d48 CrossRef

23.

Arung W, Drion P, Detry O (2016) Sepramesh and postoperative peritoneal adhesions in a rat model. Acta Chir Belg 116:1–5. https://doi.org/10.1080/00015458.2016.1181322 CrossRef

24.

Guler S, Cimen S, Hu Q, Venkatachalam AB, Alwayn I (2016) Effects of mTOR inhibitors in prevention of abdominal adhesions. J Investig Surg Off J Acad Surg Res 29(5):275–281. https://doi.org/10.3109/08941939.2016.1149643 CrossRef

25.

Skalsky I, Filova E, Szarszoi O, Parizek M, Lytvynets A, Maluskova J, Lodererova A, Brynda E, Lisa V, Burdikova Z, Capek M, Pirk J, Bacakova L (2011) A periadventitial sirolimus-releasing mesh decreased intimal hyperplasia in a rabbit model. Physiol Res 60(3):585–588PubMed

26.

Laschke MW, Haufel JM, Roller J, Schorr H, Menger MD (2009) Rapamycin, but not cyclosporine A, inhibits vascularization and incorporation of implanted surgical meshes. Transpl Int Off J Eur Soc Org Transplant 22(6):654–662. https://doi.org/10.1111/j.1432-2277.2009.00841.x CrossRef

27.

Scheuerlein H, Rauchfuss F, Gharbi A, Heise M, Settmacher U (2011) Laparoscopic incisional hernia repair after solid-organ transplantation. Transplant Proc 43(5):1783–1789. https://doi.org/10.1016/j.transproceed.2011.03.082 CrossRef

Title: Sirolimus-coated, poly(l-lactic acid)-modified polypropylene mesh with minimal intra-peritoneal adhesion formation in a rat model
Authors: S. Lu
W. Hu
Z. Zhang
Z. Ji
T. Zhang
Publication date: 01-12-2018
Publisher: Springer Paris
Published in: Hernia / Issue 6/2018
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-018-1782-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sirolimus-coated, poly(l-lactic acid)-modified polypropylene mesh with minimal intra-peritoneal adhesion formation in a rat model

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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