Abstract
Background: Effectiveness of acellular human dermis (AHD) as an alternative to synthetic mesh in contaminated fields has been described. Cellular migration after implantation and corresponding strength of attachment is not well documented. Our aim is to correlate AHD vascularization, fibroblast migration, and strength of attachment with presence of inflammatory cells in clean and contaminated fields. Materials and Methods: Lewis rats were randomized to a control and three experimental groups. AHD was placed as an onlay over the intact abdominal wall. Experimental groups (n = 72) were exposed to Staphilococcus aureus at 1 × 104, 1 × 105, or 1 × 106 by direct application; controls (n = 12) were not exposed. At 5 and 28 d, abdominal walls were explanted and tissue ingrowth assessed via tensiometry measuring energy (E) and max stress (MS) at the AHD-tissue interface. Vascularity, fibroblast migration, and inflammatory cell migration were compared using light microscopy. Results: Shear strength reported as energy and max stress were significantly greater at 28 versus 5 d in all experimental groups, remaining unchanged in controls. Plasma cells and histiocytes significantly increased in all groups; macrophages increased in experimental groups only. Vascular ingrowth increased significantly in all groups; fibroblast migration was greater in controls and 1 × 106 exposed group only. Conclusions: Contamination of AHD results in inflammatory cell influx and a surprising increase in shear strength. Interestingly, shear strength does not increase without contamination. Inflammation stimulates vascular ingrowth, but not equally significant fibroblast migration. Longer survivals are required to determine if energy and max stress of controls increase, and fibroblast migration follows vascular ingrowth.
Original language | English (US) |
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Pages (from-to) | 148-152 |
Number of pages | 5 |
Journal | Journal of Surgical Research |
Volume | 162 |
Issue number | 1 |
DOIs | |
State | Published - Jul 2010 |
Externally published | Yes |
Keywords
- acellular human dermis
- bacterial contamination
- biologics
- inflammation
- ingrowth
- shear strength
ASJC Scopus subject areas
- Surgery