Original CommunicationsImpaired balance of type I and type III procollagen mRNA in cultured fibroblasts of patients with incisional hernia*,**
Section snippets
Clinical specimens
From January to July 1999, a total of 22 patients participated in this study at the Department of Surgery. Informed consent was obtained from all patients.
Skin tissue samples were taken from the abdominal wall of healthy control patients with no previous skin incisions (n = 5; male 4, female 1; average age 61 years); from patients with a stable scar without any sign of herniation (n = 5; male 3, female 2; average age 58 years); from patients with an incisional hernia (n = 7; male 5, female 2;
Immunohistochemical analysis of collagen types I and III in tissue specimen
The immunostaining of the tissue with antibodies against collagen type I and type III showed a similar distribution in all groups. However, there is a slight increased staining for type III collagen in the group with recurrent incisional hernias. After Quantimet analysis, the resulting ratio of collagen I/III was found to be 0.62 ± 0.04 in the skin of the control group; 0.59 ± 0.01 in normal skin scars; 0.54 ± 0.02 in the skin of patients with incisional hernias; and 0.47 ± 0.01 in the skin of
Discussion
Collagen, as the principal component of the extracellular matrix, mainly consists of type I and type III collagen, which constitutes approximately 95% of all known 19 collagen types.8 Type I collagen, with its high tensile strength, is predominantly found in skin, bone, and fascia, whereas type III collagen is predominantly seen in blood vessels and parenchymatous organs. In healthy skin, type I and III collagen exist in a ratio of approximately 4:1.11 Type III collagen threads are thinner than
Conclusion
In the future, the investigation of the collagen gene expression and modulation in tissue of patients with an incisional hernia may help to define a population at risk. The incisional hernia has a known incidence of up to 20% and is the most frequent long-term complication after a laparotomy. Any development of a preventive therapeutic strategy would be of considerable socioeconomic relevance.
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2015, Journal of Surgical ResearchCitation Excerpt :If one were to directly compare our results to those reported by Si et al., one might notice a lack of relative changes in the expression of collagen type I and III genes. The authors of that report, however, used a different research technique (fibroblast culture), and the samples were obtained from hernia patients and not obese individuals [27]. In their excellent work on obese Zucker rats, Xing et al. have documented impaired postlaparotomy wound healing (worse mechanical properties when compared with nonobese rats).
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Supported by the Federal Ministry of Education and Research (Germany) grant project 01KS9503/9 for the Interdisciplinary Center for Medical Research on Biomaterials and Implant Tissue-Interfaces, The Aachen University of Technology, the German Research Foundation (Kl 1320/2-1), and ETHICON, Norderstedt, Germany.
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Reprint requests: Uwe Klinge, MD, Department of Surgery, The Technical University of Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.