Doxycycline administration improves fascial interface in hernia repair

Job C. Tharappel, Curtis E. Bower, Jennifer Whittington Harris, Sandeep K. Ramineni, David A. Puleo, J. Scott Roth

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background Despite improvements in ventral hernia repair techniques, their recurrence rates are unacceptably high. Increased levels of matrix metalloproteinases (MMPs) and reduced collagen-1 to -3 ratios are implicated in incisional hernia formation. We have recently shown doxycycline treatment for 4 wk after hernia repair reduced MMP levels, significantly increased collagen-1 to -3 ratios, and increased tensile strength of repaired interface fascia. However, this increase was not statistically significant. In this study, we extended treatment duration to determine whether this would impact the tensile strength of the repaired interface fascia. Materials and methods Thirty-two male Sprague-Dawley rats underwent incision hernia creation and subsequent repair with polypropylene mesh. The animals received either saline (n = 16) or doxycycline (n = 16) beginning from 1 day before hernia repair until the end of survival time of 6 wk (n = 16) or 12 wk (n = 16). Tissue samples were investigated for MMPs and collagen subtypes using Western blot procedures, and tensiometric analysis was performed. Results At both 6 and 12 wk after hernia repair, the tensiometric strength of doxycycline-treated mesh to fascia interface (MFI) tissue showed a statistically significant increase when compared with untreated control MFI. In both groups, collagen-1, -2, and -3 ratios were remarkably increased in doxycycline-treated MFI. At 6 wk, the doxycycline-treated MFI group showed a significant decrease in MMP-2, an increase in MMP-3, and no change in MMP-9. At 12 wk, MMP-9 showed a remarkable reduction, whereas MMP-2 and -3 protein levels increased in the doxycycline-treated MFI group. Conclusions Doxycycline administration results in significantly improved strength of repaired fascial interface tissue along with a remarkable increase in collagen-1, -2, and -3 ratios.

Original languageEnglish
Pages (from-to)692-698
Number of pages7
JournalJournal of Surgical Research
Issue number2
StatePublished - Aug 2014

Bibliographical note

Funding Information:
This research was supported by a grant from Davol Inc. , Warwick, RI. S.K.R. and D.A.P. were supported in part by the National Institutes of Health ( AR060964 ). Authors' contributions: J.C.T. and J.S.R. contributed to study design. J.C.T., C.E.B., and J.W.H. performed the surgical procedures. JCT and S.K.R. collected the data. J.C.T., D.A.P., and J.S.R. made the critical revision of the article. J.S.R. was in charge of obtaining funding and final approval of the article. All authors contributed to analysis and interpretation and participated in writing the article. The authors acknowledge the gracious support provided by Ms. Linda Combs in preparing the manuscript.


  • Collagen
  • Doxycycline
  • Hernia
  • Matrix metalloproteinase

ASJC Scopus subject areas

  • Surgery


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