BACKGROUND
Mesh-augmented surgery with polypropylene mesh (PPM) is often used in urogynecology and pelvic reconstructive surgery. However, various complications arising from its integration process cause a decrease in number of mesh-augmented surgery performed worldwide. An approach to improve mesh-tissue integration is by coating PPM with anti-inflammatory and wound healing molecules such as platelet-rich plasma (PRP) which is part of biotechnologies capable of accelerating wound healing. Estrogen is also known to have beneficial effect in wound remodelling, therefore hypoestrogenic status may have negative implication on wound healing. The mechanism of how PRP play a role in wound remodelling especially in hypoestrogenic state has not been fully described until now.
OBJECTIVE
The aim is to investigate the impact of platelet-rich plasma application to polypropylene mesh in hypoestrogenic rabbits model.
METHODS
This is a randomized controlled trial on hypoestrogenic rabbit model. Samples were categorized into either PRP or PPM groups (1:1 ratio) with a minimum sample size of 16 in each arm using simple random sampling. All samples were put into hypoestrogenic state by bilateral oophorectomy. After confirming the decrease of estradiol level, the mesh was implanted in vesicovaginal space. The samples were euthanized on either the 7th, 14th, 28th, or 90th day of the surgery. The mesh-tissue integration process will be measured by inflammatory parameters (ININ, IL-17, and IL-1b expression), angiogenesis (CD-31 expression) and collagen deposition will be assessed using Masson’s Trichrome staining.
RESULTS
This study is at the protocol development stage. A preliminary study regarding its feasibility, including preparation of hypoestrogenic rabbit model, mesh implantation in the rabbit's vesicovaginal space, PRP and amnion scaffold, has started since February 2022. The results of this study are expected to be available by the end of 2022.
CONCLUSIONS
This randomized controlled trial is designed to provide high-quality evidence on the effect of platelet-rich plasma-decellurized amnion scaffold application to polypropylene mesh in vesicovaginal space of the hypoestrogenic rabbit model.