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Research: Diaphragmatic hernia repair porcine model to compare the performance of biodegradable membranes against Gore-Tex®

Updated on 3 min read

Pediatr Surg Int

. 2023 Nov 24;40(1):7.

 doi: 10.1007/s00383-023-05584-x. https://pubmed.ncbi.nlm.nih.gov/37999778/

Diaphragmatic hernia repair porcine model to compare the performance of biodegradable membranes against Gore-Tex®

Marianna Scuglia # 1 2, Laura P Frazão # 2 3, Alice Miranda 1 2, Albino Martins 2 3, Joana Barbosa-Sequeira 1 2 4, Diana Coimbra 1 2, Adhemar Longatto-Filho 1 2 5 6, Rui L Reis 2 3, Cristina Nogueira-Silva 1 2 7, Nuno M Neves 8 9, Jorge Correia-Pinto 1 2 10

Affiliations expand

Free PMC article

Abstract

Background: Patch repair of congenital diaphragmatic hernia (CDH) using Gore-Tex® is associated with infection, adhesions, hernia recurrence, long-term musculoskeletal sequels and poor tissue regeneration. To overcome these limitations, the performance of two novel biodegradable membranes was tested to repair CDH in a growing pig model.

Methods: Twelve male pigs were randomly assigned to 3 different groups of 4 animals each, determined by the type of patch used during thoracoscopic diaphragmatic hernia repair (Gore-Tex®, polycaprolactone electrospun membrane-PCLem, and decellularized human chorion membrane-dHCM). After 7 weeks, all animals were euthanized, followed by necropsy for diaphragmatic evaluation and histological analysis.

Results: Thoracoscopic defect creation and diaphragmatic repair were performed without any technical difficulty in all groups. However, hernia recurrence rate was 0% in Gore-Tex®, 50% in PCLem and 100% in dHCM groups. At euthanasia, Gore-Tex® patches appeared virtually unchanged and covered with a fibrotic capsule, while PCLem and dHCM patches were replaced by either floppy connective tissue or vascularized and floppy regenerated membranous tissue, respectively.

Conclusion: Gore-Tex® was associated with a higher survival rate and lower recurrence. Nevertheless, the proposed biodegradable membranes were associated with better tissue integration when compared with Gore-Tex®.

Keywords: Congenital diaphragmatic hernia repair; Decellularized human chorion membrane; Electrospun fibrous mesh; Gore-Tex®; Thoracoscopic surgery.

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