Fibroblast matrix implants-a better alternative for incisional hernia repair?

Siufui Hendrawan; Jennifer Lheman; Ursula Weber; Christian Eugen Oberkofler; Astheria Eryani; René Vonlanthen; Hans Ulrich Baer

doi:10.1088/1748-605X/ad3da4

Fibroblast matrix implants-a better alternative for incisional hernia repair?

Biomed Mater. 2024 Apr 25;19(3). doi: 10.1088/1748-605X/ad3da4.

Authors

Siufui Hendrawan^{1

2}, Jennifer Lheman¹, Ursula Weber^{1

3}, Christian Eugen Oberkofler⁴, Astheria Eryani⁵, René Vonlanthen⁴, Hans Ulrich Baer^{1

3

6}

Affiliations

¹ Tarumanagara Human Cell Technology Laboratory, Faculty of Medicine, Tarumanagara University, Jakarta 11440, Indonesia.
² Department of Biochemistry and Molecular Biology, Faculty of Medicine, Tarumanagara University, Jakarta 11440, Indonesia.
³ Baermed, Centre of Abdominal Surgery, Hirslanden Clinic, 8032 Zürich, Switzerland.
⁴ Vivévis AG, Viszeral-, Tumor- und Roboterchirurgie, Kappelistrasse 7, 8002 Zürich, Switzerland.
⁵ Department of Histology, Faculty of Medicine, Tarumanagara University, Jakarta 11440, Indonesia.
⁶ Department of Visceral and Transplantation Surgery, University of Bern, 3012 Bern, Switzerland.

PMID: 38604155
DOI: 10.1088/1748-605X/ad3da4

Abstract

The standard surgical procedure for abdominal hernia repair with conventional prosthetic mesh still results in a high recurrence rate. In the present study, we propose a fibroblast matrix implant (FMI), which is a three-dimensional (3D) poly-L-lactic acid scaffold coated with collagen (matrix) and seeded with fibroblasts, as an alternative mesh for hernia repair. The matrix was seeded with fibroblasts (cellularized) and treated with a conditioned medium (CM) of human Umbilical Cord Mesenchymal Stem Cells (hUC-MSC). Fibroblast proliferation and function were assessed and compared between treated with CM hUC-MSC and untreated group, 24 h after seeding onto the matrix (n= 3). To study the matricesin vivo,the hernia was surgically created on male Sprague Dawley rats and repaired with four different grafts (n= 3), including a commercial mesh (mesh group), a matrix without cells (cell-free group), a matrix seeded with fibroblasts (FMI group), and a matrix seeded with fibroblasts and cultured in medium treated with 1% CM hUC-MSC (FMI-CM group).In vitroexamination showed that the fibroblasts' proliferation on the matrices (treated group) did not differ significantly compared to the untreated group. CM hUC-MSC was able to promote the collagen synthesis of the fibroblasts, resulting in a higher collagen concentration compared to the untreated group. Furthermore, thein vivostudy showed that the matrices allowed fibroblast growth and supported cell functionality for at least 1 month after implantation. The highest number of fibroblasts was observed in the FMI group at the 14 d endpoint, but at the 28 d endpoint, the FMI-CM group had the highest. Collagen deposition area and neovascularization at the implantation site were observed in all groups without any significant difference between the groups. FMI combined with CM hUC-MSC may serve as a better option for hernia repair, providing additional reinforcement which in turn should reduce hernia recurrence.

Keywords: 3D PLLA scaffold; CM hUC-MSC; collagen; hernia; matrix.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animals
Biocompatible Materials / chemistry
Cell Proliferation*
Cells, Cultured
Collagen* / chemistry
Culture Media, Conditioned / pharmacology
Fibroblasts* / metabolism
Hernia, Abdominal / surgery
Herniorrhaphy* / instrumentation
Herniorrhaphy* / methods
Humans
Incisional Hernia* / surgery
Male
Materials Testing
Mesenchymal Stem Cells* / cytology
Polyesters / chemistry
Rats
Rats, Sprague-Dawley*
Surgical Mesh*
Tissue Scaffolds* / chemistry
Umbilical Cord / cytology

Substances

Collagen
Polyesters
poly(lactide)
Culture Media, Conditioned
Biocompatible Materials