Diaphragmatic hernia repair porcine model to compare the performance of biodegradable membranes against Gore‑Tex

Published: 24 November 2023 Background Patch repair of congenital diaphragmatic hernia (CDH) using Gore-Tex® is associated with infection, adhesions, hernia recurrence, long-term musculoskeletal sequels and poor tissue regeneration. To overcome these limitations, the performance of two novel biodegradable membranes was tested to repair CDH in a growing pig model. Methods Twelve male pigs were randomly assigned to 3 diferent groups of 4 animals each, determined by the type of patch used during thoracoscopic diaphragmatic hernia repair (Gore-Tex®, polycaprolactone electrospun membrane-PCLem, and decellularized human chorion membrane-dHCM). After 7 weeks, all animals were euthanized, followed by necropsy for diaphragmatic evaluation and histological analysis. Results Thoracoscopic defect creation and diaphragmatic repair were performed without any technical difculty in all groups. However, hernia recurrence rate was 0% in Gore-Tex®, 50% in PCLem and 100% in dHCM groups. At euthanasia, Gore-Tex® patches appeared virtually unchanged and covered with a fbrotic capsule, while PCLem and dHCM patches were replaced by either foppy connective tissue or vascularized and foppy regenerated membranous tissue, respectively. Conclusion Gore-Tex® was associated with a higher survival rate and lower recurrence. Nevertheless, the proposed biodegradable membranes were associated with better tissue integration when compared with Gore-Tex®. Open access funding provided by FCT|FCCN (b-on). This work was supported by the Portuguese Foundation for Science and Technology (FCT) for the grant of LP (PD/BD/128103/2016 and FSE/ POCH/PD/169/2013), the IF grant of AM (IF/00376/2014) and the project Cells4_IDs of NM-N (PTDC/BTM-SAL/28882/2017). The authors would like to thank the contributions to this research from the project “TERM RES Hub – Scientifc Infrastructure for Tissue Engineering and Regenerative Medicine”, reference PINFRA/22190/2016 (Norte01-0145-FEDER-022190), funded by the Portuguese National Science Foundation (FCT) in cooperation with the Northern Portugal Regional Coordination and Development Commission (CCDR-N), for providing relevant lab facilities, state-of-the art equipment and highly qualifed human resources.