Diaphragmatic hernia repair porcine model to compare the performance of biodegradable membranes against Gore-Tex®
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Read the article on link.springer.com ↗Article · Nov 2023 · 1 min read
In brief
In brief
This porcine model study compares Gore-Tex® against two biodegradable membranes (polycaprolactone and decellularized chorion) for thoracoscopic CDH repair. While Gore-Tex® showed superior recurrence prevention (0% vs 50-100%), biodegradable options demonstrated better tissue integration and regeneration, suggesting potential for improved long-term outcomes with further material optimization.
Written by the GCMD Library team from the article.
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®.