1. Evaluation of a biodegradable polyurethane patch for repair of diaphragmatic hernia in a rat model: A pilot study
- Author
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Theodorou, Christina M, Taylor, Alan, Lee, Su Yeon, Cortez, Lia Molina, Fu, Huikang, Pivetti, Christopher D, Zhang, Chaoxing, Stasyuk, Anastasiya, Hao, Dake, Kumar, Priyadarsini, Farmer, Diana L, Liao, Jun, Brown, Erin G, Hong, Yi, and Wang, Aijun
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Rare Diseases ,Rats ,Animals ,Hernias ,Diaphragmatic ,Congenital ,Pilot Projects ,Polyurethanes ,Prospective Studies ,Diaphragm ,Retrospective Studies ,Congenital diaphragmatic hernia ,Bioengineering ,Patch repair ,Diaphragmatic hernia repair ,Paediatrics and Reproductive Medicine ,Pediatrics ,Clinical sciences ,Paediatrics - Abstract
IntroductionCongenital diaphragmatic hernia (CDH) repair is an area of active research. Large defects requiring patches have a hernia recurrence rate of up to 50%. We designed a biodegradable polyurethane (PU)-based elastic patch that matches the mechanical properties of native diaphragm muscle. We compared the PU patch to a non-biodegradable Gore-Tex™ (polytetrafluoroethylene) patch.MethodsThe biodegradable polyurethane was synthesized from polycaprolactone, hexadiisocyanate and putrescine, and then processed into fibrous PU patches by electrospinning. Rats underwent 4 mm diaphragmatic hernia (DH) creation via laparotomy followed by immediate repair with Gore-Tex™ (n = 6) or PU (n = 6) patches. Six rats underwent sham laparotomy without DH creation/repair. Diaphragm function was evaluated by fluoroscopy at 1 and 4 weeks. At 4 weeks, animals underwent gross inspection for recurrence and histologic evaluation for inflammatory reaction to the patch materials.ResultsThere were no hernia recurrences in either cohort. Gore-Tex™ had limited diaphragm rise compared to sham at 4 weeks (1.3 mm vs 2.9 mm, p = 0.003), but no difference was found between PU and sham (1.7 mm vs 2.9 mm, p = 0.09). There were no differences between PU and Gore-Tex™ at any time point. Both patches formed an inflammatory capsule, with similar thicknesses between cohorts on the abdominal (Gore-Tex™ 0.07 mm vs. PU 0.13 mm, p = 0.39) and thoracic (Gore-Tex™ 0.3 mm vs. PU 0.6 mm, p = 0.09) sides.ConclusionThe biodegradable PU patch allowed for similar diaphragmatic excursion compared to control animals. There were similar inflammatory responses to both patches. Further work is needed to evaluate long-term functional outcomes and further optimize the properties of the novel PU patch in vitro and in vivo.Level of evidenceLevel II, Prospective Comparative Study.
- Published
- 2023