title: Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair.
abstract: The objective of this study was to evaluate the mechanical and histological properties of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh (Phasix™ ST) compared to partially absorbable (Ventralight™ ST), fully absorbable (Phasix™), and biologically derived (Strattice™) meshes in a porcine model of ventral hernia repair.
  
  
  
  Bilateral abdominal surgical defects were created in twenty-four Yucatan pigs, repaired with intraperitoneal (Phasix™ ST, Ventralight™ ST) or retromuscular (Phasix™, Strattice™) mesh, and evaluated at 12 and 24 weeks (n = 6 mesh/group/time point).
  
  
  
  Prior to implantation, Strattice™ demonstrated significantly higher (p < 0.001) strength (636.6 ± 192.1 N) compared to Ventralight™ ST (324.3 ± 37.1 N), Phasix™ ST (206.9 ± 11.3 N), and Phasix™ (200.6 ± 25.2 N). At 12 and 24 weeks, mesh/repair strength was significantly greater than NAW (p < 0.01 in all cases), and no significant changes in strength were observed for any meshes between 12 and 24 weeks (p > 0.05). Phasix™ mesh/repair strength was significantly greater than Strattice™ (p < 0.001) at 12 and 24 weeks, and Ventralight™ ST mesh/repair strength was significantly greater than Phasix™ ST mesh (p < 0.05) at 24 weeks. At 12 and 24 weeks, Phasix™ ST and Ventralight™ ST were associated with mild inflammation and minimal-mild fibrosis/neovascularization, with no significant differences between groups. At both time points, Phasix™ was associated with minimal-mild inflammation/fibrosis and mild neovascularization. Strattice™ was associated with minimal inflammation/fibrosis, with minimal neovascularization at 12 weeks, which increased to mild by 24 weeks. Strattice™ exhibited significantly less neovascularization than Phasix™ at 12 weeks and significantly greater inflammation at 24 weeks due to remodeling.
  
  
  
  Phasix™ ST demonstrated mechanical and histological properties comparable to partially absorbable (Ventralight™ ST) and fully resorbable (Phasix™) meshes at 12 and 24 weeks in this model. Data also suggest that fully absorbable meshes with longer-term resorption profiles may provide improved mechanical and histological properties compared to biologically derived scaffolds.
authors.affiliation: Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, 171 Meeting Street, Box G-B, Providence, RI, 02912, USA. jeffrey_scott@brown.edu.|C. R. Bard, Inc. (Davol), Warwick, RI, USA. jeffrey_scott@brown.edu.
authors.forename: Jeffrey R
authors.identifier: 0000-0002-2604-8403
authors.initials: JR
authors.lastname: Scott
authors.affiliation: Covalent Bio, LLC, St. Louis, MO, USA.
authors.forename: Corey R
authors.initials: CR
authors.lastname: Deeken
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Martindale
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rosen
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D020099:Coated Materials, Biocompatible; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods; D006885:Hydroxybutyrates; D008422:Materials Testing; D023421:Models, Animal; D013526:Surgical Mesh; D013552:Swine; D014945:Wound Healing
chemical_list: D020099:Coated Materials, Biocompatible; D006885:Hydroxybutyrates
keywords: Absorbable; Biologically derived; Hernia repair; Mesh; Phasix™; Poly-4-hydroxybutyrate