Evaluation of a Biodegradable Polyurethane Patch for Repair of Diaphragmatic Hernia in a Rat Model: A Pilot Study
| Autor: | Christina M. Theodorou, Alan Taylor, Su Yeon Lee, Lia Molina Cortez, Huikang Fu, Christopher D. Pivetti, Chaoxing Zhang, Anastasiya Stasyuk, Dake Hao, Priyadarsini Kumar, Diana L. Farmer, Jun Liao, Erin G. Brown, Yi Hong, Aijun Wang |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Diaphragmatic hernia repair
Diaphragm Polyurethanes Patch repair Pilot Projects Bioengineering Congenital diaphragmatic hernia General Medicine Pediatrics Article Rats Paediatrics and Reproductive Medicine Congenital Pediatrics Perinatology and Child Health Animals Surgery Prospective Studies Digestive Diseases Lung Retrospective Studies Hernias Diaphragmatic |
| Zdroj: | J Pediatr Surg Journal of pediatric surgery, vol 58, iss 5 |
| Popis: | IntroductionCongenital diaphragmatic hernia (CDH) repair is an area of active research. Large defects requiring patches have a hernia recurrence rate of up to 50%. We designed a biodegradable polyurethane (PU)-based elastic patch that matches the mechanical properties of native diaphragm muscle. We compared the PU patch to a non-biodegradable Gore-Tex™ (polytetrafluoroethylene) patch.MethodsThe biodegradable polyurethane was synthesized from polycaprolactone, hexadiisocyanate and putrescine, and then processed into fibrous PU patches by electrospinning. Rats underwent 4mm diaphragmatic hernia (DH) creation via laparotomy followed by immediate repair with Gore-Tex™ (n=6) or PU (n=6) patches. Six rats underwent sham laparotomy without DH creation/repair. Diaphragm function was evaluated by fluoroscopy at 1 and 4 weeks. At 4 weeks, animals underwent gross inspection for recurrence and histologic evaluation for inflammatory reaction to the patch materials.ResultsThere were no hernia recurrences in either cohort. Gore-Tex™ had limited diaphragm rise compared to sham at 4 weeks (1.3mm vs 2.9mm, p=0.003), but no difference was found between PU and sham (1.7mm vs 2.9mm, p=0.09). There were no differences between PU and Gore-Tex™ at any time point. Both patches formed an inflammatory capsule, with similar thicknesses between cohorts on the abdominal (Gore-Tex™ 0.07mm vs. PU 0.13mm, p=0.39) and thoracic (Gore-Tex™ 0.3mm vs. PU 0.6mm, p=0.09) sides.ConclusionThe biodegradable PU patch allowed for similar diaphragmatic excursion compared to control animals. There were similar inflammatory responses to both patches. Further work is needed to evaluate long-term functional outcomes and further optimize the properties of the novel PU patch in vitro and in vivo.Level of evidenceLevel II, Prospective Comparative Study. |
| Databáze: | OpenAIRE |
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