Author:
Scuglia Marianna,Frazão Laura P.,Miranda Alice,Martins Albino,Barbosa-Sequeira Joana,Coimbra Diana,Longatto-Filho Adhemar,Reis Rui L.,Nogueira-Silva Cristina,Neves Nuno M.,Correia-Pinto Jorge
Abstract
Abstract
Background
Patch repair of congenital diaphragmatic hernia (CDH) using Gore-Tex® is associated with infection, adhesions, hernia recurrence, long-term musculoskeletal sequels and poor tissue regeneration. To overcome these limitations, the performance of two novel biodegradable membranes was tested to repair CDH in a growing pig model.
Methods
Twelve male pigs were randomly assigned to 3 different groups of 4 animals each, determined by the type of patch used during thoracoscopic diaphragmatic hernia repair (Gore-Tex®, polycaprolactone electrospun membrane-PCLem, and decellularized human chorion membrane-dHCM). After 7 weeks, all animals were euthanized, followed by necropsy for diaphragmatic evaluation and histological analysis.
Results
Thoracoscopic defect creation and diaphragmatic repair were performed without any technical difficulty in all groups. However, hernia recurrence rate was 0% in Gore-Tex®, 50% in PCLem and 100% in dHCM groups. At euthanasia, Gore-Tex® patches appeared virtually unchanged and covered with a fibrotic capsule, while PCLem and dHCM patches were replaced by either floppy connective tissue or vascularized and floppy regenerated membranous tissue, respectively.
Conclusion
Gore-Tex® was associated with a higher survival rate and lower recurrence. Nevertheless, the proposed biodegradable membranes were associated with better tissue integration when compared with Gore-Tex®.
Funder
Fundação para a Ciência e a Tecnologia
IF grant
Cells4_IDs
Universidade do Minho
Publisher
Springer Science and Business Media LLC
Subject
General Medicine,Surgery,Pediatrics, Perinatology and Child Health