Download PDF
CC BY 4.0 · Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2024; 39(01): 217712352023rbcp0799pt
DOI: 10.5935/2177-1235.2023RBCP0799-PT
Artigo Original

Reparação da parede abdominal com membranas acelulares de pericárdio bovino - Parte II - Análises histológicas e morfométricas

Article in several languages: português | English
LUIZ FERNANDO FRASCINO 
1   Hospital do Coração de São José do Rio Preto, São José do Rio Preto, SP, Brasil.
2   Instituto Frascino, Unidade de Publicação e Pesquisa, São José do Rio Preto, SP, Brasil.
,
LUCA REIS FRASCINO 
2   Instituto Frascino, Unidade de Publicação e Pesquisa, São José do Rio Preto, SP, Brasil.
3   Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil.
,
JORGE ALBERTO THOME 
4   Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil.
,
MOACIR FERNANDES DE GODOY 
4   Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil.
› Author Affiliations
› Further Information
  Permissions and Reprints

▪ RESUMO

Introdução:

Análise histológica é a principal ferramenta de avaliação de biopróteses acelulares, em sua maioria em caráter experimental. O objetivo é analisar histologicamente a matriz acelular de pericárdio bovino em reparações de parede abdominal implantada em humanos.

Método:

De uma série de 30 reparações com a membrana, 3 pacientes foram submetidas a revisão cirúrgica não relacionada aos implantes, aos 13, 22 e 23 meses de pós-operatório, obtendo-se biópsias das áreas previamente implantadas. Além da avaliação dos aspectos básicos de biocompatibilidade e neoformação tecidual, as lâminas foram digitalizadas e submetidas a análise computadorizada com o software ImageJ para quantificação da cinética de degradação das membranas, associada à análise da dimensão fractal das amostras. Os valores obtidos para porcentagens de membrana residual tiveram suas médias comparadas por análise de variância (ANOVA) e pelo teste T de Student não pareado, também utilizado para os valores da quantificação da dimensão fractal.

Resultados:

Foi demonstrada a biocompatibilidade do material, com neoformação tecidual, deposição de colágeno e tecido celularizado de aspecto normal, sem reações locais importantes. Fragmentos residuais da membrana foram quantificados em 40%±7% aos 13 meses, em 20%±6% aos 22 meses e em 17%±6% aos 23 meses de pós-operatório, com a análise da dimensão fractal indicando uma progressiva degradação dos implantes, com significância estatística entre 13 meses e as amostras tardias.

Conclusão:

Os resultados atestaram a funcionalidade do pericárdio bovino acelular sob diferentes níveis de estresse mecânico nas reparações da parede abdominal em humanos.

Descritores:

Matriz extracelular - Hérnia abdominal - Parede abdominal - Próteses e implantes - Telas cirúrgicas - Bioprótese - Pericárdio

Instituição: Clínica Spani Vendramin, Belém, PA, Brasil.




Publication History

Received: 14 March 2023

Accepted: 05 December 2023

Article published online:
20 May 2025

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

Bibliographical Record
LUIZ FERNANDO FRASCINO, LUCA REIS FRASCINO, JORGE ALBERTO THOME, MOACIR FERNANDES DE GODOY. Reparação da parede abdominal com membranas acelulares de pericárdio bovino - Parte II - Análises histológicas e morfométricas. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2024; 39: 217712352023rbcp0799pt.
DOI: 10.5935/2177-1235.2023RBCP0799-PT
 

  • REFERÊNCIAS

  • 1 Baumann DP, Butler CE. Bioprosthetic mesh in abdominal wall reconstruction. Semin Plast Surg 2012; 26 (01) 18-24
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Panayi AC, Orgill DP. Current Use of Biological Scaffolds in Plastic Surgery. Plast Reconstr Surg 2019; 143 (01) 209-220
    CrossrefPubMedSearch in Google Scholar
  • 3 Brown BN, Badylak SF. Extracellular matrix as an inductive scaffold for functional tissue reconstruction. Transl Res 2014; 163 (04) 268-285
    PubMedSearch in Google Scholar
  • 4 Sternlicht MD, Werb Z. How matrix metalloproteinases regulate cell behavior. Annu Rev Cell Dev Biol 2001; 17: 463-516
    CrossrefPubMedSearch in Google Scholar
  • 5 Blatnik J, Jin J, Rosen M. Abdominal hernia repair with bridging acellular dermal matrix--an expensive hernia sac. Am J Surg 2008; 196 (01) 47-50
    PubMedSearch in Google Scholar
  • 6 Costa A, Naranjo JD, Londono R, Badylak SF. Biologic Scaffolds. Cold Spring Harb Perspect Med 2017; 7 (09) a025676
    CrossrefPubMedSearch in Google Scholar
  • 7 Smart NJ, Bloor S. Durability of biologic implants for use in hernia repair: a review. Surg Innov 2012; 19 (03) 221-229
    PubMedSearch in Google Scholar
  • 8 Liang HC, Chang Y, Hsu CK, Lee MH, Sung HW. Effects of crosslinking degree of an acellular biological tissue on its tissue regeneration pattern. Biomaterials 2004; 25 (17) 3541-3552
    CrossrefPubMedSearch in Google Scholar
  • 9 Mestak O, Spurkova Z, Benkova K, Vesely P, Hromadkova V, Miletin J. et al. Comparison of Cross-linked and Non-Cross-linked Acellular Porcine Dermal Scaffolds for Long-term Full-Thickness Hernia Repair in a Small Animal Model. Eplasty 2014; 14: e22
    PubMedSearch in Google Scholar
  • 10 Wotton FT, Akoh JA. Rejection of Permacol mesh used in abdominal wall repair: a case report. World J Gastroenterol 2009; 15 (34) 4331-4333
    PubMedSearch in Google Scholar
  • 11 Cheung D, Brown L, Sampath R. Localized inferior orbital fibrosis associated with porcine dermal collagen xenograft orbital floor implant. Ophthalmic Plast Reconstr Surg 2004; 20 (03) 257-259
    PubMedSearch in Google Scholar
  • 12 Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods 2012; 9 (07) 671-675
    CrossrefPubMedSearch in Google Scholar
  • 13 Backes AR, Bruno OM. Técnicas de estimativa de dimensão fractal aplicadas em imagens digitais. Relatórios Técnicos. São Carlos: Universidade de São Paulo; 2005. . Disponível em: http://repositorio.icmc.usp.br//handle/RIICMC/6846
    Search in Google Scholar
  • 14 Acellular Matrix Treatment Market – Global Industry Analysis, Size, Share, Growth, Trends and Forecast, 2021 – 2031. Disponível em: https://www.transparencymarketresearch.com/acellular-dermal-matrix-treatment-market.html
  • 15 Knight RL, Wilcox HE, Korossis SA, Fisher J, Ingham E. The use of acellular matrices for the tissue engineering of cardiac valves. Proc Inst Mech Eng H 2008; 222 (01) 129-143
    CrossrefPubMedSearch in Google Scholar
  • 16 Iyyanki TS, Dunne LW, Zhang Q, Hubenak J, Turza KC, Butler CE. Adipose-derived stem-cell-seeded non-cross-linked porcine acellular dermal matrix increases cellular infiltration, vascular infiltration, and mechanical strength of ventral hernia repairs. Tissue Eng Part A 2015; 21 (3-4): 475-485
    CrossrefPubMedSearch in Google Scholar
  • 17 Friess W. Collagen--biomaterial for drug delivery. Eur J Pharm Biopharm 1998; 45 (02) 113-136
    PubMedSearch in Google Scholar
  • 18 Robinson TN, Clarke JH, Schoen J, Walsh MD. Major mesh-related complications following hernia repair: events reported to the Food and Drug Administration. Surg Endosc 2005; 19 (12) 1556-1560
    CrossrefPubMedSearch in Google Scholar
  • 19 Klosterhalfen B, Klinge U, Hermanns B, Schumpelick V. Pathology of traditional surgical nets for hernia repair after long-term implantation in humans. Chirurg 2000; 71 (01) 43-51 . German
    PubMedSearch in Google Scholar
  • 20 Melman L, Jenkins ED, Hamilton NA, Bender LC, Brodt MD, Deeken CR. et al. Early biocompatibility of crosslinked and non-crosslinked biologic meshes in a porcine model of ventral hernia repair. Hernia 2011; 15 (02) 157-164
    CrossrefPubMedSearch in Google Scholar
  • 21 Connor J, McQuillan D, Sandor M, Wan H, Lombardi J, Bachrach N. et al. Retention of structural and biochemical integrity in a biological mesh supports tissue remodeling in a primate abdominal wall model. Regen Med 2009; 4 (02) 185-195
    CrossrefPubMedSearch in Google Scholar
  • 22 Brennan EP, Reing J, Chew D, Myers-Irvin JM, Young EJ, Badylak SF. Antibacterial activity within degradation products of biological scaffolds composed of extracellular matrix. Tissue Eng 2006; 12 (10) 2949-2955
    PubMedSearch in Google Scholar
  • 23 Harth KC, Broome AM, Jacobs MR, Blatnik JA, Zeinali F, Bajaksouzian S. et al. Bacterial clearance of biologic grafts used in hernia repair: an experimental study. Surg Endosc 2011; 25 (07) 2224-2229
    PubMedSearch in Google Scholar
  • 24 Badylak SF, Freytes DO, Gilbert TW. Extracellular matrix as a biological scaffold material: Structure and function. Acta Biomater 2009; 5 (01) 1-13
    PubMedSearch in Google Scholar
  • 25 Boháč M, Danišovič Ľ, Koller J, Dragúňová J, Varga I. What happens to an acellular dermal matrix after implantation in the human body? A histological and electron microscopic study. Eur J Histochem 2018; 62 (01) 2873
    CrossrefPubMedSearch in Google Scholar
  • 26 Katerinaki E, Zanetto U, Sterne GD. Histological appearance of Strattice tissue matrix used in breast reconstruction. J Plast Reconstr Aesthet Surg 2010; 63 (12) e840-1
    CrossrefPubMedSearch in Google Scholar
  • 27 Salzberg CA, Dunavant C, Nocera N. Immediate breast reconstruction using porcine acellular dermal matrix (Strattice™): long-term outcomes and complications. J Plast Reconstr Aesthet Surg 2013; 66 (03) 323-328
    CrossrefPubMedSearch in Google Scholar
  • 28 Costa A, Naranjo JD, Turner NJ, Swinehart IT, Kolich BD, Shaffiey SA. et al. Mechanical strength vs. degradation of a biologically-derived surgical mesh over time in a rodent full thickness abdominal wall defect. Biomaterials 2016; 108: 81-90
    PubMedSearch in Google Scholar
  • 29 Carey LE, Dearth CL, Johnson SA, Londono R, Medberry CJ, Daly KA. et al. In vivo degradation of 14C-labeled porcine dermis biologic scaffold. Biomaterials 2014; 35 (29) 8297-8304
    CrossrefPubMedSearch in Google Scholar
  • 30 de Castro Brás LE, Shurey S, Sibbons PD. Evaluation of crosslinked and non-crosslinked biologic prostheses for abdominal hernia repair. Hernia 2012; 16 (01) 77-89
    CrossrefPubMedSearch in Google Scholar
  • 31 Badylak S, Kokini K, Tullius B, Whitson B. Strength over time of a resorbable bioscaffold for body wall repair in a dog model. J Surg Res 2001; 99 (02) 282-287
    CrossrefPubMedSearch in Google Scholar
  • 32 López Cano M, Armengol Carrasco M, Quiles Pérez MT, Arbós Vía MA. Biological implants in abdominal wall hernia surgery. Cir Esp 2013; 91 (04) 217-223
    PubMedSearch in Google Scholar
  • 33 Lotan AM, Cohen D, Nahmany G, Heller L, Babai P, Freier-Dror Y. et al. Histopathological Study of Meshed Versus Solid Sheet Acellular Dermal Matrices in a Porcine Model. Ann Plast Surg 2018; 81 (05) 609-614
    PubMedSearch in Google Scholar
  • 34 Limpert JN, Desai AR, Kumpf AL, Fallucco MA, Aridge DL. Repair of abdominal wall defects with bovine pericardium. Am J Surg 2009; 198 (05) e60-5
    CrossrefPubMedSearch in Google Scholar
  • 35 Shieh MK. Bovine Pericardium in Complex Abdominal Wall Reconstruction in Patients with Obesity or Morbid Obesity. Bariatric Times 2014; 11 (09) 14-18
    Search in Google Scholar
  • 36 Keane TJ, Londono R, Turner NJ, Badylak SF. Consequences of ineffective decellularization of biologic scaffolds on the host response. Biomaterials 2012; 33 (06) 1771-1781
    PubMedSearch in Google Scholar
  • 37 Tierney CM, Haugh MG, Liedl J, Mulcahy F, Hayes B, O’Brien FJ. The effects of collagen concentration and crosslink density on the biological, structural and mechanical properties of collagen-GAG scaffolds for bone tissue engineering. J Mech Behav Biomed Mater 2009; 2 (02) 202-209
    PubMedSearch in Google Scholar
  • 38 Badylak SF. Decellularized allogeneic and xenogeneic tissue as a bioscaffold for regenerative medicine: factors that influence the host response. Ann Biomed Eng 2014; 42 (07) 1517-1527
    PubMedSearch in Google Scholar
  • 39 Cavallo JA, Roma AA, Jasielec MS, Ousley J, Creamer J, Pichert MD. et al. Remodeling characteristics and collagen distribution in biological scaffold materials explanted from human subjects after abdominal soft tissue reconstruction: an analysis of scaffold remodeling characteristics by patient risk factors and surgical site classifications. Ann Surg 2015; 261 (02) 405-415
    CrossrefPubMedSearch in Google Scholar
  • 40 Ventral Hernia Working Group. Breuing K, Butler CE, Ferzoco S, Franz M, Hultman CS, Kilbridge JF. et al. Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 2010; 148 (03) 544-558
    CrossrefPubMedSearch in Google Scholar
  • 41 Reece IJ, van Noort R, Martin TR, Black MM. The physical properties of bovine pericardium: a study of the effects of stretching during chemical treatment in glutaraldehyde. Ann Thorac Surg 1982; 33 (05) 480-485
    PubMedSearch in Google Scholar
  • 42 Schmidt CE, Baier JM. Acellular vascular tissues: natural biomaterials for tissue repair and tissue engineering. Biomaterials 2000; 21 (22) 2215-2231
    CrossrefPubMedSearch in Google Scholar
  • 43 Jayakrishnan A, Jameela SR. Glutaraldehyde as a fixative in bioprostheses and drug delivery matrices. Biomaterials 1996; 17 (05) 471-484
    PubMedSearch in Google Scholar
  • 44 Gorman SP, Scott EM, Russell AD. Antimicrobial activity, uses and mechanism of action of glutaraldehyde. J Appl Bacteriol 1980; 48 (02) 161-190
    PubMedSearch in Google Scholar
  • 45 Freytes DO, Stoner RM, Badylak SF. Uniaxial and biaxial properties of terminally sterilized porcine urinary bladder matrix scaffolds. J Biomed Mater Res B Appl Biomater 2008; 84 (02) 408-414
    CrossrefPubMedSearch in Google Scholar
  • 46 Faleris JA, Hernandez RM, Wetzel D, Dodds R, Greenspan DC. In-vivo and in-vitro histological evaluation of two commercially available acellular dermal matrices. Hernia 2011; 15 (02) 147-156
    CrossrefPubMedSearch in Google Scholar
  • 47 Freytes DO, Tullius RS, Valentin JE, Stewart-Akers AM, Badylak SF. Hydrated versus lyophilized forms of porcine extracellular matrix derived from the urinary bladder. J Biomed Mater Res A 2008; 87 (04) 862-872
    CrossrefPubMedSearch in Google Scholar
  • 48 Bottino MC, Jose MV, Thomas V, Dean DR, Janowski GM. Freeze-dried acellular dermal matrix graft: effects of rehydration on physical, chemical, and mechanical properties. Dent Mater 2009; 25 (09) 1109-1115
    CrossrefPubMedSearch in Google Scholar