A commentary on “Evaluation of the histological and biomechanical properties of poly-4-hydroxybutyrate (P4HB) scaffold for pelvic organ prolapse, as compared to polypropylene mesh in a rabbit model”

Excerpt

This prospective animal study aimed to evaluate the histological and biomechanical properties of a fully absorbable macroporous monofilament (P4HB) scaffold following abdominal and vaginal implantation in rabbit model, as compared to a lightweight polypropylene (PP) mesh. A total of 16 female (retired breeder) New Zealand White rabbits were obtained. Rabbits were randomly assigned to 3- (n = 8) and 9-month (n = 8) time points. P4HB scaffold used in this study had a fiber diameter of 100 μm, pore size of 1.5 mm², weight of 55.4 g/m², and thickness of 280 μm. The lightweight PP mesh (Upsylon, Boston Scientific) used in this study had a fiber diameter of 100 μm, pore size of 2.8 mm², weight of 25 g/m², and thickness of 200 μm. At each time point, animals were randomly assigned to either PP mesh or P4HB scaffold groups. Histological analysis: Acute inflammation, chronic inflammation, granulation tissue, fibroblast maturation, collagen deposition, neovascularization elastic fibers, and collagen deposition were scored on a scale of 0–3 (0 = none, 1 = scant, 2 = moderate 3 = abundant) on H&E-stained specimens. Biomechanical analysis: Uniaxial (load-to-failure) tensile testing was performed on the samples. A pre-load of 0.5 N was applied to the specimens, and the dimensions (length, width, thickness) were measured using a digital caliper. Device-tissue specimens were subjected to tensile extension at a strain rate of 0.25 mm/s until failure, and the resultant load was recorded. Ultimate tensile strength, stiffness, and load at ultimate tensile strength were recorded. …