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Ultrasound shear wave elastography effectively predicts integrity of ventral hernia repair using acellular dermal matrix augmented with platelet-rich plasma (PRP).

Publication ,  Journal Article
Van Eps, JL; Chaudhry, A; Fernandez-Moure, JS; Boada, C; Chegireddy, V; Cabrera, FJ; Tang, S; Tasciotti, E; Righetti, R
Published in: Surg Endosc
September 2019

BACKGROUND: Complications of ventral hernia repair (VHR) may be investigated by computed tomography or ultrasound (US) but neither modality gives a quantifiable metric of repair quality short of identifying hernia recurrence. Platelet-rich plasma (PRP), a growth factor-rich autologous blood product, has been shown to improve incorporation of native tissue with bioprosthetics. In this study, we investigate the effect of PRP on the incorporation and mechanical integrity of a non-crosslinked porcine acellular dermal matrix (pADM) in a rodent model of VHR and the correlative ability of ultrasound shear wave elastography (US-SWE) to assess repair quality. METHODS: PRP was isolated from whole blood of Lewis rats. Twenty-eight Lewis rats underwent chronic VHR using either pADM alone or augmented with autologous PRP prior to non-invasive imaging assessment and specimen harvest at either 3 or 6 months. US-SWE was performed to estimate the Young's modulus prior to histological assessment and data from PRP-treated rodents were compared to controls. RESULTS: Implanted pADM was easily distinguishable by US-SWE imaging in all cases analyzed in this study. The mean Young's modulus measured was 1.78 times and 2.54 times higher in PRP-treated samples versus control at 3-month and 6-month time points respectively (p < 0.05). At 3 months, qualitative and quantitative histology revealed decreased inflammation and improved incorporation in PRP-treated samples along the implant/abdominal wall interface. At 6 months, the PRP cohort had no hernia recurrence and preserved ADM integrity from immunologic degradation, while all control animals suffered hernia recurrence (4/6) or extreme ADM thinning (2/6). CONCLUSION: This study confirms both the efficacy of PRP in augmenting VHR using pADM, as well as the reliability of US-SWE to non-invasively predict the quality of VHR. Although further human studies are necessary, this work supports PRP use to improve VHR outcomes and US-SWE potential for bedside non-invasive hernia characterization.

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Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

September 2019

Volume

33

Issue

9

Start / End Page

2802 / 2811

Location

Germany

Related Subject Headings

  • Surgical Mesh
  • Surgery
  • Rats, Inbred Lew
  • Rats
  • Predictive Value of Tests
  • Platelet-Rich Plasma
  • Male
  • Herniorrhaphy
  • Hernia, Ventral
  • Elasticity Imaging Techniques
 

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Van Eps, J. L., Chaudhry, A., Fernandez-Moure, J. S., Boada, C., Chegireddy, V., Cabrera, F. J., … Righetti, R. (2019). Ultrasound shear wave elastography effectively predicts integrity of ventral hernia repair using acellular dermal matrix augmented with platelet-rich plasma (PRP). Surg Endosc, 33(9), 2802–2811. https://doi.org/10.1007/s00464-018-6571-8
Van Eps, Jeffrey L., Anuj Chaudhry, Joseph S. Fernandez-Moure, Christian Boada, Vishwanath Chegireddy, Fernando J. Cabrera, Songyuan Tang, Ennio Tasciotti, and Raffaella Righetti. “Ultrasound shear wave elastography effectively predicts integrity of ventral hernia repair using acellular dermal matrix augmented with platelet-rich plasma (PRP).Surg Endosc 33, no. 9 (September 2019): 2802–11. https://doi.org/10.1007/s00464-018-6571-8.
Van Eps JL, Chaudhry A, Fernandez-Moure JS, Boada C, Chegireddy V, Cabrera FJ, et al. Ultrasound shear wave elastography effectively predicts integrity of ventral hernia repair using acellular dermal matrix augmented with platelet-rich plasma (PRP). Surg Endosc. 2019 Sep;33(9):2802–11.
Van Eps, Jeffrey L., et al. “Ultrasound shear wave elastography effectively predicts integrity of ventral hernia repair using acellular dermal matrix augmented with platelet-rich plasma (PRP).Surg Endosc, vol. 33, no. 9, Sept. 2019, pp. 2802–11. Pubmed, doi:10.1007/s00464-018-6571-8.
Van Eps JL, Chaudhry A, Fernandez-Moure JS, Boada C, Chegireddy V, Cabrera FJ, Tang S, Tasciotti E, Righetti R. Ultrasound shear wave elastography effectively predicts integrity of ventral hernia repair using acellular dermal matrix augmented with platelet-rich plasma (PRP). Surg Endosc. 2019 Sep;33(9):2802–2811.
Journal cover image

Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

September 2019

Volume

33

Issue

9

Start / End Page

2802 / 2811

Location

Germany

Related Subject Headings

  • Surgical Mesh
  • Surgery
  • Rats, Inbred Lew
  • Rats
  • Predictive Value of Tests
  • Platelet-Rich Plasma
  • Male
  • Herniorrhaphy
  • Hernia, Ventral
  • Elasticity Imaging Techniques