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• W2014328002 abstract "Introduction: the purpose of this study was to perform a systematic histologic analysis of an allogeneic biologic scaffold explanted from abdominal wall repair sites of human subjects at the time of a clinically-indicated abdominal re-exploration. We hypothesized that higher collagen type I:III ratios and more favorable remodeling scores of explanted scaffolds would inversely correlate with subject Charlson Comorbidity Index (CCI), ACS Wound Class, and CDC National Nosocomial Infections Surveillance (NNIS) Risk Index assessed at time of both scaffold implantation (T1) and explantation (T2). Methods: Biopsies of the allogeneic scaffolds were obtained from the abdominal wall repair sites of n=15 patients during a subsequent abdominal re-exploration for comparision. De novo allogeneic scaffolds and biopsies were stained with H&E, and evaluated according to a semi-quantitative scoring system for characteristics of remodeling [cell infiltration, cell types, host extracellular matrix (ECM) deposition, scaffold degradation, fibrous encapsulation, and neovascularization] and a mean composite score. De novo allogeneic scaffolds and biopsies were also stained with sirius red (SR) for collagen I & fast green (FG) for collagen III, photographed under polarized light, and analyzed to determine the SR:FG ratio. Results: Mean subject age at T2, M:F ratio, mean duration of scaffold indwelling, and ratio of onlay:inlay:sublay location were 55.9 years, 7:8, 681.3 days, 3:1:11, respectively. SR/FG significantly correlated with ACS wound class at T1 (p=0.01), CCI at T1 (p=0.02), and CCI at T2 (p=0.02). Cell infiltration significantly correlated with subject age at T2 (p=0.00), CCI at T1 (p=0.00), and CCI at T2 (p=0.00). Fibrous encapsulation significantly correlated with scaffold location (p=0.03). Neovascularization significantly correlated with subject age at T2 (p=0.00). When duration of scaffold indwelling was categorized as 0, 1-6, 7-12, 13-18, 19-24, and >24 months, greater indwelling durations significantly correlated with greater composite remodeling score (p=0.00), cell infiltration (p=0.00), cell type (p=0.01), extracellular matrix deposition (p=0.03), and neovascularization (p=0.02). Conclusions: As hypothesized, greater ratios of collagen I:III significantly correlated with greater ACS wound class at T1, and greater CCI at both T1 and T2. Mean composite scores for remodeling did not significantly correlate with subject characteristics or wound class. However, significant correlations were found between greater cell infiltration and greater CCI at both T1 and T2; and greater fibrous encapsulation and inlay location. With greater indwelling duration, scaffolds demonstrated significantly greater overall remodeling, cell infiltration, favorable cell types, ECM deposition, and neovascularization, but not scaffold degradation or fibrous encapusulation. Host characteristics and surgical site assessments may predict degree of remodeling following abdominal wall repair for costly biologic scaffolds." @default.
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• W2014328002 date "2012-02-01" @default.
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• W2014328002 title "Remodeling Characteristics and Collagen Distribution in Biologic Scaffold Materials Explanted From Human Subjects After Abdominal Wall Reconstruction: An Analysis of Scaffold Remodeling by Host Characteristics and Surgical Site Classification" @default.
• W2014328002 doi "https://doi.org/10.1016/j.jss.2011.11.491" @default.
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