Abdominal Wall Defects – surgical innovations based on an understanding of biological interactions.

Abdominal wall defect repair is a common surgical procedure where adverse interaction between prosthetic material and human tissue is a major problem.

HERMUS (Hernia Multi-University Study group) focuses on a paradigm change using autologous full-thickness skin graft (FTSG) as reinforcing material.

This innovative method requires detailed knowledge about the biological mechanisms behind desired tissue integration as well as adverse interactions.By the application of FTSG in a murine model, we have studied the processes behind tissue remodelling.

The translational biology-surgery circle has been completed by the randomised multicentre SHIFT-trial on intraperitoneal application of FTSG.

The effect of hyperglycaemia induced by surgery on ECM remodelling, tissue inflammation and hyaluronan metabolism will be explored.

With blood samples and tissue biopsies, collagen isoform metabolism, the constitutional composition of fibroblasts, collagens and hyaluronan will all be investigated in relation to hernia recurrence.Using a LUC-mouse model, a second translational chain will investigate effects of stem cells applied to the FTSG on the host’s inflammatory response.

Is it possible to influence graft integration through precoating of the FTSG with stem cells and augmented by hyaluronan dressing?

If so, medical treatment may be a complement to hernia-surgery.Results from these studies can immediately be transferred to clinical practice and to the refinement of novel surgical techniques.