Original Article
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World J Gastroenterol. Aug 28, 2010; 16(32): 4031-4038
Published online Aug 28, 2010. doi: 10.3748/wjg.v16.i32.4031
Extracellular matrices for gastrointestinal surgery: Ex vivo testing and current applications
Jens Hoeppner, Goran Marjanovic, Peter Helwig, Ulrich Theodor Hopt, Tobias Keck
Jens Hoeppner, Goran Marjanovic, Ulrich Theodor Hopt, Tobias Keck, Department of General and Visceral Surgery, University of Freiburg, Freiburg 79106, Germany
Peter Helwig, Department of Orthopedics and Traumatology, University of Freiburg, Freiburg 79106, Germany
Author contributions: Hoeppner J and Keck T designed the research; Hoeppner J, Marjanovic G and Helwig P performed the experiments; Hoeppner J and Marjanovic G analyzed the data; Keck T and Hopt UT helped to revise the manuscript; Hoeppner J wrote the manuscript.
Correspondence to: Jens Hoeppner, MD, Department of General and Visceral Surgery, University of Freiburg, Hugstettter Str. 55, Freiburg 79106, Germany. jens.hoeppner@uniklinik-freiburg.de
Telephone: +49-761-2702401 Fax: +49-761-2702804
Received: April 4, 2010
Revised: May 26, 2010
Accepted: June 2, 2010
Published online: August 28, 2010

AIM: To assess the effects of bile and pancreatic juice on structural and mechanical resistance of extracellular matrices (ECMs) in vitro.

METHODS: Small-intestinal submucosa (SIS), porcine dermal matrix (PDM), porcine pericardial matrix (PPM) and bovine pericardial matrix (BPM) were incubated in human bile and pancreatic juice in vitro. ECMs were examined by macroscopic observation, scanning electron microscopy (SEM) and testing of mechanical resistance.

RESULTS: PDM dissolved within 4 d after exposure to bile or pancreatic juice. SIS, PPM and PDM retained their integrity for > 60 d when incubated in either digestive juice. The effect of bile was found to be far more detrimental to mechanical stability than pancreatic juice in all tested materials. In SIS, the loss of mechanical stability after incubation in either of the digestive secretions was less distinct than in PPM and BPM [mFmax 4.01/14.27 N (SIS) vs 2.08/5.23 N (PPM) vs 1.48/7.89 N (BPM)]. In SIS, the extent of structural damage revealed by SEM was more evident in bile than in pancreatic juice. In PPM and BPM, structural damage was comparable in both media.

CONCLUSION: PDM is less suitable for support of gastrointestinal healing. Besides SIS, PPM and BPM should also be evaluated experimentally for gastrointestinal indications.

Keywords: Extracellular matrix, Intestinal regeneration, Ex-vivo testing, Gastrointestinal surgery, Gastrointestinal fistula, Bioscaffolding