Abstract
Background: Incisional hernia is one of the most common complications of abdominal surgery, and repairs are associated with significant recurrence rates. Mesh repairs are associated with the best outcomes, but failures are not uncommon. Doxycycline has been demonstrated to enhance mesh hernia repair outcomes with associated increases in collagen deposition and improved tensiometric strength. This study compares the outcomes of incisional hernia repair with doxycycline administration and the antioxidant tempol. Materials and methods: Twenty-eight male Sprague Dawley rats underwent a midline hernia creation and an intraabdominal polypropylene mesh repair. The animals were administered saline, doxycycline, tempol, or both, daily for 8 wk. The abdominal wall was harvested at 8 wk and tensiometric strength and biochemical analysis was performed. Results: The tensiometric strength of the repair was increased in all experimental groups. Collagen type 1 deposition was increased, and collagen type 3 deposition was decreased in each of the experimental groups relative to control. There was no difference in MMP-2 and MMP-9 levels between control and experimental groups. Conclusions: The hernia repair strength is equally enhanced with the administration of doxycycline or tempol. Dual therapy provided no benefit over treatment with either single agent. All treatment groups had an increase in collagen type 1:3 ratios, but the mechanism is not well understood. The benefits of antioxidant treatment following hernia repair are similar to treatment with doxycycline. Given the high frequency of incisional hernia repair failures, this study has implications for improving outcomes following ventral hernia repair through the use of either doxycycline or antioxidant therapy.
Original language | English |
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Pages (from-to) | 144-149 |
Number of pages | 6 |
Journal | Journal of Surgical Research |
Volume | 247 |
DOIs | |
State | Published - Mar 2020 |
Bibliographical note
Funding Information:JSR has grant funding from Bard and Miromatrix; he is a consultant for Bard, Johnson & Johnson, and Allergan, and he owns stock in Miromatrix. The other authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
Funding Information:
The authors acknowledge the support provided by Ms. Linda Combs in preparing the manuscript. Author Contributions: JT and JSR contributed to the study design and collection of data; JT performed the surgical procedures; VM and CT completed the analysis and critical revisions of the manuscript. Funding Source: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Dr Madabhushi is supported by the University of Kentucky, Center for Clinical and Translational Science TL1 Grant (NIH: TL1TR001997).
Funding Information:
The authors acknowledge the support provided by Ms. Linda Combs in preparing the manuscript. Author Contributions: JT and JSR contributed to the study design and collection of data; JT performed the surgical procedures; VM and CT completed the analysis and critical revisions of the manuscript. Funding Source: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Dr Madabhushi is supported by the University of Kentucky, Center for Clinical and Translational Science TL1 Grant (NIH: TL1TR001997).
Publisher Copyright:
© 2019 Elsevier Inc.
Keywords
- Antioxidants
- Collagen
- Doxycycline
- Hernia repair
- Incisional hernia
- Mesh
ASJC Scopus subject areas
- Surgery