Artikel
Optimization of Wound Healing through Coating of Meshes for Hernia Reparation with the Anti-Ageing Hormone DHEA
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Veröffentlicht: | 20. Mai 2011 |
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Gliederung
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Introduction: Synthetical meshes being used for hernia reparation cause a foreign body response accompanied by chronic inflammation and subsequent immurement of the implant, which favours mesh related complications such as recurrence or migration. Considering the anti-inflammatory and immune-modulatory potential of the physiological adrenal steroid hormone DHEA (Dehydroepiandosterone), we tested in a rat model, whether coating of a PVDF-mesh with DHEA is able to modify the local tissue response.
Materials and methods: We implemented meshes coated with or without DHEA in an inlay position regarding the abdominal wall in 60 male rats after randomisation. The hormone was released from the mesh within six hours after implantation. On days 7, 21 and 90 the animals were sacrificed, the abdominal wall was explanted and investigated with immunhistochemistry of CD 68 (macrophages), vWF and eNOS (vessels) and Sirius Red (collagen) as well as HE staining (granuloma size and scar formation) to detect the effects of DHEA on wound healing.
Results: With DHEA there was a significant improvement of the wound healing particularly after 21 and 90 days. We could detect a smaller foreign body reaction, less macrophages and the building of mature collagen that was notably more structured and not as frizzly. This resulted in a better collagen I/III ratio. The minimal distance of bridging, i.e. the minimal gap between two filaments without building of scars, was significantly lower in the DHEA group after 21 and 90 days.
Conclusion: DHEA improves wound healing at the interface of PVDF filaments. Interestingly, despite its short-term release kinetic we found lasting changes of the tissue´s inflammatory reaction. A detailed knowledge of the molecular effect of this steroid hormone can be useful for a more specific pharmacotherapy of the peri-implant wound healing.