gms | German Medical Science

128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

Optimization of Wound Healing through Coating of Meshes for Hernia Reparation with the Anti-Ageing Hormone DHEA

Meeting Abstract

  • Anjali Röth - Universitätsklinikum Aachen, Klinik für Allgemein- und Viszeralchirurgie, Aachen
  • Anette Fiebeler - Medizinische Hochschule Hannover, Klinik für Nieren- und Hochdruckerkrankungen, Hannover
  • Holger Lehert - Universitätsklinikum Aachen, Klinik für Allgemein- und Viszeralchirurgie, Aachen
  • Ulf Neumann - Universitätsklinik RWTH Aachen, Klinik für Allgemein- und Viszeralchirurgie, Aachen
  • Uwe Klinge - Universitätsklinikum Aachen, Klinik für Allgemein- und Viszeralchirurgie, Aachen

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch171

DOI: 10.3205/11dgch171, URN: urn:nbn:de:0183-11dgch1712

Veröffentlicht: 20. Mai 2011

© 2011 Röth et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

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.