Body wall repair using small intestinal submucosa seeded with cells.
OBJECTIVE
Prosthetic repair of large ventral abdominal wall defects has been associated with high complication rates. This study was aimed at applying tissue engineering to body wall replacement.


METHODS
Syngeneic Lewis rats underwent harvest of skeletal muscle specimens. Once expanded in vitro, skeletal muscle cells or fibroblasts were suspended in a collagen gel. All animals underwent creation of a 2.5- x 3-cm abdominal wall defect. The defect was repaired with the cell-seeded gel placed in between 2 pieces of small intestinal submucosa (SIS). The control group was repaired by SIS with acellular gel. Animals were killed at different time-points for histologic and mechanical examination. Statistical analysis was by analysis of variance (ANOVA).


RESULTS
Abdominal wall hernia was present in 6 of 24 fibroblast-seeded constructs (25%), 5 of 21 skeletal muscle cell-seeded constructs (23.9%), and 16 of 21 acellular grafts (76.2%), respectively (P <.05). At harvest, cell-seeded constructs were thicker with better cellular infiltration, whereas acellular grafts were thin, low in cell density, and poor in mechanical resistance.


CONCLUSIONS
Unlike acellular collagen matrices, engineered cellular constructs have better cell infiltration and mechanical performance. Tissue engineering may be a viable alternative for body-wall replacement.
Lai
Jin-Yao
JY
Department of Pediatric Surgery, Chang-Gung Children's Hospital, Kweishan, Taoyuan, Taiwan.
Chang
Pei-Yeh
PY
Lin
Jer-Nan
JN
D034861:Abdominal Wall / Q000002:abnormalities* / Q000601:surgery; D000818:Animals; D001672:Biocompatible Materials; D002478:Cells, Cultured; D004195:Disease Models, Animal; D005109:Extracellular Matrix / Q000637:transplantation; D005347:Fibroblasts; D007421:Intestine, Small / Q000166:cytology / Q000637:transplantation*; D008297:Male; D018482:Muscle, Skeletal / Q000166:cytology; D051381:Rats; D011917:Rats, Inbred Lew; D023822:Tissue Engineering
D001672:Biocompatible Materials