A hernia occurs when part of an internal organ bulges through a weak area of muscle, with most hernias occurring in the abdomen. Surgical hernia repair is one of the most commonly performed surgeries in the US. While using prosthetic mesh as a reinforcement has significantly improved surgical outcomes, the rate of hernia recurrence remains high (30-50%). Current prosthetic materials are associated with numerous complications, including increased risk of infection, prosthetic shrinkage and host-foreign body reactions, leading to a diminished postoperative patient quality of life. The recent introduction of various biologic prosthetic meshes derived from modified human or porcine tissue have demonstrated lower rates of infection as compared to their synthetic counterparts. Equally important, effective immobilization of the mesh against the abdominal wall is critical to hernia repair success. Currently, sutures and staples are used to hold synthetic and biologic meshes in place, but these can be a source of nerve damage and chronic discomfort. Thus, there continues to be a need to develop alternative fixation methods that can effectively secure the mesh to the abdominal wall as well as improve long- term biocompatibility of these meshes. Marine mussels provided the inspiration for the new technology presented in this proposal. By releasing rapidly hardening, tightly binding adhesive proteins, marine mussels have the ability to anchor themselves to various surfaces in a wet, turbulent, and saline environment. Both natural proteins and their synthetic mimics can bind strongly to various substrates ranging from biological tissues to metal surfaces. In this proposal, biomimetic synthetic adhesives will be combined with a natural scaffold to create a novel bioadhesive prosthetic. The intent of such a construct is to create an effective repair with minimized long-term infection rate and chronic patient discomfort typically associated with permanent prosthetic materials. The feasibility of using such a material for hernia repair will be tested.
Bioadhesive Membrane Construct for Hernia Repair Hernia repair is one of the most frequently performed surgical procedures in the United States. Current repair methods and materials have exhibited mixed success, but each has limitations such as high recurrence rate and persistent patient discomfort. The development and evaluation of a novel bioadhesive membrane construct for hernia repair is described here. ? ? ?
| Murphy, John L; Vollenweider, Laura; Xu, Fangmin et al. (2010) Adhesive performance of biomimetic adhesive-coated biologic scaffolds. Biomacromolecules 11:2976-84 |
