Augmentation of the insufficient tissue bed for surgical repair of hypospadias using acellular matrix grafts:A proof of concept study

Abstract

Acellular matrices produced by tissue decellularisation are reported to have tissue integrative properties. We examined the potential for incorporating acellular matrix grafts during procedures where there is an inadequate natural tissue bed to support an enduring surgical repair. Hypospadias is a common congenital defect requiring surgery, but associated with long-term complications due to deficiencies in the quality and quantity of the host tissue bed at the repair site. Biomaterials were implanted as single on-lay grafts in a peri-urethral position in male pigs. Two acellular tissue matrices were compared: full-thickness porcine acellular bladder matrix (PABM) and commercially-sourced cross-linked acellular matrix from porcine dermis (Permacol™). Anatomical and immunohistological outcomes were assessed 3 months post-surgery. There were no complications and surgical sites underwent full cosmetic repair. PABM grafts were fully incorporated, whilst Permacol™ grafts remained palpable. Immunohistochemical analysis indicated a non-inflammatory, remodelling-type response to both biomaterials. PABM implants showed extensive stromal cell infiltration and neovascularisation, with a significantly higher density of cells (p < 0.001) than Permacol™, which showed poor cellularisation and partial encapsulation. This study supports the anti-inflammatory and tissue-integrative nature of non-crosslinked acellular matrices and provides proof-of-principle for incorporating acellular matrices during surgical procedures, such as in primary complex hypospadias repair.

Metadata

Item Type:	Article
Authors/Creators:	Morgante, Debora Radford, Anna Abbas, Syed K. Ingham, Eileen Subramaniam, Ramnath Southgate, Jennifer https://orcid.org/0000-0002-0135-480X
Copyright, Publisher and Additional Information:	Funding Information: We thank Dr Karen Hogg (Bioscience Technology Facility, Department of Biology, University of York) for assistance with TissueGnostics analysis, Dr Amy Glover (Research Technician) for histology and immunohistochemistry support and Maria Caballero (Erasmus overseas student) for her help with histology analysis. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research work described here was funded through the Medical Technologies Innovation and Knowledge Centre (phase 2 ? Regenerative Devices), funded by the EPSRC under grant number EP/N00941X/1 as Proof of Concept awards: PoC023 and PoC045 and partially by Grow MedTech?s Proof of Feasibility programme supported by UKRI Research England?s Connecting Capability Fund [project code: CCF11-7795]. AR was supported by the European Society of Paediatric Urology. AR and DM were registered as PhD students with the Hull York Medical School. JS is supported by a programme grant from York Against Cancer. The work leading to the development of PABM was originally funded by the Biotechnology and Biological Sciences Research Council (BBSRC) on grants E20352 and BB/E527220/1. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research work described here was funded through the Medical Technologies Innovation and Knowledge Centre (phase 2 – Regenerative Devices), funded by the EPSRC under grant number EP/N00941X/1 as Proof of Concept awards: PoC023 and PoC045 and partially by Grow MedTech’s Proof of Feasibility programme supported by UKRI Research England’s Connecting Capability Fund [project code: CCF11-7795]. AR was supported by the European Society of Paediatric Urology. AR and DM were registered as PhD students with the Hull York Medical School. JS is supported by a programme grant from York Against Cancer. The work leading to the development of PABM was originally funded by the Biotechnology and Biological Sciences Research Council (BBSRC) on grants E20352 and BB/E527220/1. Publisher Copyright: © The Author(s) 2021.
Keywords:	Acellular matrix,biomaterial,hypospadias repair,surgery,tissue integration
Dates:	Published (online): 20 April 2021 Accepted: 10 February 2021
Institution:	The University of York
Academic Units:	The University of York > Faculty of Sciences (York) > Hull York Medical School (York) The University of York > Faculty of Sciences (York) > Biology (York) The University of York > Faculty of Sciences (York) > Biology (York) > Jack Birch Unit for Molecular Carcinogenesis (York) The University of York > Faculty of Social Sciences (York) > Economics and Related Studies (York)
Funding Information:	Funder Grant number YORK AGAINST CANCER None
Depositing User:	Pure (York)
Date Deposited:	17 Feb 2021 09:30
Last Modified:	24 Jan 2025 00:10
Published Version:	https://doi.org/10.1177/2041731421998840
Status:	Published online
Refereed:	Yes
Identification Number:	10.1177/2041731421998840
Related URLs:	http://www.scopus.com/inward/record.url?...
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:171247