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Bone marrow-derived mesenchymal stromal cells and platelet-rich plasma on a collagen matrix to improve fascial healing

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Abstract

Objective

To demonstrate improved healing of a midline laparotomy after application of mesenchymal stromal cells and platelet-rich plasma on a collagen matrix and introduce a potential cellular-based therapy for the prevention of incisional hernia formation.

Background

Up to 10 % of laparotomies are complicated by postoperative incisional hernias. Despite continuous improvements in surgical technique and technology, hernia rates have remained constant. Cell-based therapies focused on augmentation of the body’s natural healing properties could reduce hernia formation.

Methods

Midline laparotomies were performed on 42 Lewis rats. Three groups were studied: (1) primary repair only, (2) primary repair with CollaTape™ (CoTa) overlay and platelet-rich plasma (PRP), and (3) primary repair with CoTa overlay and PRP and bone marrow-derived mesenchymal stromal cells (BM-MSCs). Abdominal wall fascia was recovered at 4 and 8 weeks in each group. Biomechanical testing and histological evaluation was performed.

Results

At 4 weeks, there was a twofold increase in tensile strength between groups 1 and 2 and a fourfold increase between groups 1 and 3 (p < 0.001). Group 3 had a 320 % increase in total energy absorption at 4 weeks compared to group 1 and a 142 % increase at 8 weeks (p < 0.001). Vascularization and collagen abundance were significantly increased in group 3 at both time points.

Conclusion

The addition of BM-MSCs, PRP, and CoTa led to a marked improvement in abdominal wall strength and energy absorption. Histologic evaluation confirmed increased vascularity and collagen abundance consistent with the biomechanical findings. Application of this therapy may ultimately reduce incisional hernia formation.

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Acknowledgments

Funding was provided by the American Hernia Society/Lifestyle Resident Research Award 2010.

Conflict of interest

There are no other disclosures.

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Authors and Affiliations

  1. Department of Surgery, Division of Acute Care Surgery, University of Michigan Medical Center, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA

    J. J. Heffner

  2. Department of General Surgery, St. Elizabeth Health Center/Northeast Ohio Medical University, Youngstown, OH, USA

    J. W. Holmes, J. P. Ferrari & H. A. Dorion

  3. Department of Biological Sciences, Youngstown State University, Youngstown, OH, USA

    J. Krontiris-Litowitz, D. L. Fagan & J. C. Perko

  4. Department of Mechanical and Industrial Engineering, Youngstown State University, Youngstown, OH, USA

    H. Marie

Authors
  1. J. J. Heffner
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  2. J. W. Holmes
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  3. J. P. Ferrari
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  4. J. Krontiris-Litowitz
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  5. H. Marie
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  6. D. L. Fagan
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  8. H. A. Dorion
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Correspondence to J. J. Heffner.

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Heffner, J.J., Holmes, J.W., Ferrari, J.P. et al. Bone marrow-derived mesenchymal stromal cells and platelet-rich plasma on a collagen matrix to improve fascial healing. Hernia 16, 677–687 (2012). https://doi.org/10.1007/s10029-012-0941-2

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  • DOI: https://doi.org/10.1007/s10029-012-0941-2

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