Effect on the tensile strength of human acellular dermis (Epiflex®) of in-vitro incubation simulating an open abdomen setting.
BACKGROUND
The use of human acellular dermis (hAD) to close open abdomen in the treatment process of severe peritonitis might be an alternative to standard care. This paper describes an investigation of the effects of fluids simulating an open abdomen environment on the biomechanical properties of Epiflex® a cell-free human dermis transplant.


METHODS
hAD was incubated in Ringers solution, blood, urine, upper gastrointestinal (upper GI) secretion and a peritonitis-like bacterial solution in-vitro for 3 weeks. At day 0, 7, 14 and 21 breaking strength was measured, tensile strength was calculated and standard fluorescence microscopy was performed.


RESULTS
hAD incubated in all five of the five fluids showed a decrease in mean breaking strength at day 21 when compared to day 0. However, upper GI secretion was the only incubation fluid that significantly reduced the mechanical strength of Epiflex after 21 days of incubation when compared to incubation in Ringer's solution.


CONCLUSIONS
hAD may be a suitable material for closure of the open abdomen in the absence of upper GI leakage and pancreatic fistulae.
Mario
M
Vitacolonna
Michael
M
Mularczyk
Florian
F
Herrle
Torsten J
TJ
Schulze
Hans
H
Haupt
Matthias
M
Oechsner
Lothar R
LR
Pilz
Peter
P
Hohenberger
Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, University Medical Centre Mannheim, Heidelberg University, Theodor Kutzer Ufer 1-3, 68167 Mannheim, Germany. eric.roessner@umm.de.
Eric Dominic
ED
Rössner
D000005:Abdomen; D062088:Acellular Dermis; D001696:Biomechanical Phenomena; D001826:Body Fluids; D005750:Gastric Juice; D006801:Humans; D007419:Intestinal Secretions; D007552:Isotonic Solutions; D008856:Microscopy, Fluorescence; D000077331:Ringer's Solution; D013718:Tensile Strength; D046509:Tissue Culture Techniques
D007552:Isotonic Solutions; D000077331:Ringer's Solution