Prevention of incisional hernias using mesenchymal stromal cells and platelet-rich plasma treated collagen matrix tape

Abstract

Each year, there are over four million abdominal wall surgeries performed in the United States. These surgeries have a 10% - 20% chance of developing into an incisional hernia. Although new surgical techniques and technologies have been introduced to decrease the chance of a hernia occurring, there has been no method developed that can consistently decreases the likelihood of an incisional hernia. In a novel approach, this study investigated the healing effect the combination of platelet-rich plasma (PRP) and mesenchymal stromal cells (MSCs) on collagen tape had on abdominal wall fascia repair. In the study, midline laparotomies were performed on Lewis rats and the incisions were treated with the addition of PRP, PRP + MSCs, and no treatment. At four and eight weeks, the fascia was extracted and uniaxial tensile tests were performed on the samples to obtained maximum stress, modulus of elasticity and modulus of toughness. Two other experiments were performed to investigate if different cell concentrations of MSCs varied the results of the tensile test data. In the preliminary trial, the combination of PRP + MSCs showed a significant increase at four and eight weeks for maximum stress, modulus of elasticity, and modulus of toughness as compared to the non-treated and PRP treated groups. The dosage trials did not present any clear correlation between the cell concentrations of 2.5x104, 5x104, 1x105, 2.5x105, and 5x10 MSCs and the mechanical properties. Results from the elastographic strain analysis showed excellent correlation between the elastography and tensile test strain. Computational modeling led to the development of a preliminary finite element model. In conclusion, the combination of PRP + MSCs demonstrated an enhancement of mechanical properties over the PRP treated and non-treated samples. Further work will need to be done to see if there is a correlation between MSC dosage and improvement in the healing of fascia. Other work will focus on furthering the finite element and incorporating localized modulu