Bone Marrow-derived Mesenchymal Stromal Cells And Platelet-rich Plasma On A Collagen Matrix To Improve Fascial Healing
chronic wounds; closure; growth-factor; Hernia; in-vitro; incisional hernia; Mesenchymal; PRP (platelet-rich plasma); rat; repair; Stem; stem-cells; Stromal; Surgery; suture; tissue
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. 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. Midline laparotomies were performed on 42 Lewis rats. Three groups were studied: (1) primary repair only, (2) primary repair with CollaTape (TM) (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. 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. 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.
Heffner J J; Holmes J W; Ferrari J P; Krontiris-Litowitz J; Marie H; Fagan D L; Perko J C; Dorion H A
Hernia
2012
2012-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/s10029-012-0941-2" target="_blank" rel="noreferrer noopener">10.1007/s10029-012-0941-2</a>
In vivo skin elastography with high-definition optical videos
biomechanical properties; Dermatology; Dermatology; mechanical properties; optical flow; skin elastography; strain image; suction cup; tissue; tissue abnormality; visualization
Background/aims Continuous measurements of biomechanical properties of skin provide potentially valuable information to dermatologists for both clinical diagnosis and quantitative assessment of therapy. This paper presents an experimental study on in vivo imaging of skin elastic properties using high-definition optical videos. The objective is to (i) investigate whether skin property abnormalities can be detected in the computed strain elastograms, (ii) quantify property abnormalities with a Relative Strain Index (RSI), so that an objective rating system can be established, (iii) determine whether certain skin diseases are more amenable to optical elastography and (iv) identify factors that may have an adverse impact on the quality of strain elastograms. Methods There are three steps in optical skin elastography: (i) skin deformations are recorded in a video sequence using a high-definition camcorder, (ii) a dense motion field between two adjacent video frames is obtained using a robust optical flow algorithm, with which a cumulative motion field between two frames of a larger interval is derived and (iii) a strain elastogram is computed by applying two weighted gradient filters to the cumulative motion data. Results Experiments were carried out using videos of 25 patients. In the three cases presented in this article (hypertrophic lichen planus, seborrheic keratosis and psoriasis vulgaris), abnormal tissues associated with the skin diseases were successfully identified in the elastograms. There exists a good correspondence between the shape of property abnormalities and the area of diseased skin. The computed RSI gives a quantitative measure of the magnitude of property abnormalities that is consistent with the skin stiffness observed on clinical examinations. Conclusions Optical elastography is a promising imaging modality that is capable of capturing disease-induced property changes. Its main advantage is that an elastogram presents a continuous description of the spatial variation of skin properties on the pixel level that would otherwise be impossible with other sensors. Its value will be further enhanced when used with a point-wise measuring device such as a cutometer that yields absolute elasticity values.
Zhang Y; Brodell R T; Mostow E N; Vinyard C J; Marie H
Skin Research and Technology
2009
2009-08
Journal Article
<a href="http://doi.org/10.1111/j.1600-0846.2009.00351.x" target="_blank" rel="noreferrer noopener">10.1111/j.1600-0846.2009.00351.x</a>