Body wall repair using small intestinal submucosa seeded with cells

Area of Science:

• Regenerative Medicine
• Biomaterials Science
• Surgical Innovation

Background:

• Prosthetic repair of large ventral abdominal wall defects often leads to high complication rates.
• Existing methods present challenges in achieving optimal outcomes for complex hernia repairs.

Purpose of the Study:

• To investigate the efficacy of tissue engineering for body wall replacement in abdominal wall defects.
• To compare the performance of cell-seeded engineered constructs versus acellular grafts.

Main Methods:

• Skeletal muscle cells or fibroblasts were expanded in vitro and suspended in a collagen gel.
• Abdominal wall defects in Lewis rats were repaired using cell-seeded gels with small intestinal submucosa (SIS) or acellular gel controls.
• Histologic and mechanical examinations were performed at various time points.

Main Results:

• Cell-seeded constructs showed significantly lower hernia rates (25% fibroblast, 23.9% muscle cells) compared to acellular grafts (76.2%).
• Engineered cellular constructs exhibited increased thickness and superior cellular infiltration.
• Acellular grafts were characterized by thinness, low cell density, and poor mechanical resistance.

Conclusions:

• Engineered cellular constructs offer enhanced cell infiltration and mechanical performance over acellular collagen matrices.
• Tissue engineering presents a viable and potentially superior alternative for abdominal body wall reconstruction.
• This approach holds promise for improving outcomes in the repair of large ventral abdominal wall defects.