Fetal abdominal wall repair with a collagen biomatrix in an experimental sheep model for gastroschisis.
We evaluated the regeneration of the abdominal wall using a dual-layer collagen biomatrix, and the protective effect on the bowel of fetal abdominal wall repair in a fetal sheep model for gastroschisis. In 14 fetal lambs, the abdominal wall was opened at 79 days' gestation, creating a gastroschisis. In group 1, the gastroschisis was left uncovered. In group 2, the bowel was repositioned, and the defect was closed by suturing a collagen biomatrix into the abdominal wall. A cesarean section was performed at 140 days' gestation, and macroscopic and histological evaluation was performed. In the five lambs with a gastroschisis, the eviscerated part of the bowel was coalescent, showed extensive adhesions, and was covered by fibrous peel. In group 2, the abdominal wall had closed, with a firm connection to the native abdominal wall. The biomatrix was largely degraded and replaced by connective tissue with collagen and fibroblasts, neovascularisation, and scattered muscle cells. Minor or no adhesions of the bowel and no peel formation were observed. Abdominal wall tissue replacement using a collagen biomatrix was feasible in fetal lambs, resulting in a closed abdominal wall at birth. Immediate closure of the gastroschisis strongly diminished or prevented bowel adhesions and peel formation.
Roelofs
Luc A J
LA
Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. L.Roelofs@uro.umcn.nl
Eggink
Alex J
AJ
Hulsbergen-van de Kaa
Christina A
CA
van den Berg
Paul P
PP
van Kuppevelt
Toin H
TH
van Moerkerk
Herman T B
HT
Crevels
A Jane
AJ
Lotgering
Fred K
FK
Feitz
Wout F J
WF
Wijnen
Rene M H
RM
D034861:Abdominal Wall / Q000473:pathology*; D000818:Animals; D003094:Collagen / Q000378:metabolism* / Q000648:ultrastructure; D004195:Disease Models, Animal; D005109:Extracellular Matrix / Q000648:ultrastructure; D005260:Female; D005333:Fetus / Q000473:pathology*; D020139:Gastroschisis / Q000473:pathology*; D011247:Pregnancy; D034561:Sheep, Domestic; D014945:Wound Healing
D003094:Collagen