Tissuepatch is biocompatible and seals iatrogenic membrane defects in a rabbit model. (11th December 2017) - Engels, Alexander C.
Abstract: Objective: To evaluate novel sealing techniques for their biocompatibility and sealing capacity of iatrogenic fetal membrane defects in a pregnant rabbit model. Method: At day 23 of gestation (term = d31), a standardized fetoscopy was performed through a 14G cannula. The resulting fetal membrane defect was closed with condensed collagen, collagen with fibrinogen, Tissuepatch, Duraseal, or a conventional collagen plug (Lyostypt) as reference. At d30, the fetuses were harvested and full thickness fetal membrane samples were analyzed. The study consisted of 2 consecutive parts: (1) biocompatibility testing by fetal survival, apoptosis, and infiltration of polymorphonuclear cells in the membranes and (2) the efficacy to seal fetal membrane defects. Results: Three sealants (collagen with fibrinogen, Duraseal, or Lyostypt) were associated with a higher fetal mortality compared to control unmanipulated littermates and hence were excluded from further analysis. Tissuepatch was biocompatible, and amniotic fluid levels were comparable to those of control untouched littermates. Compared to the condensed collagen, Tissuepatch was also easier in surgical handling and induced limited cell proliferation. Conclusion: Tissuepatch had the best biocompatibility and efficacy in sealing an iatrogenic fetal membrane defect in the pregnant rabbit compared to other readily available sealants. Abstract : What's already known about this topic? Iatrogenic PPROM is a major risk factor of fetoscopic procedures. So far, used sealants are not efficient to prevent iPPROM. Further research is needed. What does this study add? We screened 5 sealants for biocompatibility and efficacy to seal fetal membrane defects. Tissuepatch was biocompatible and had a good efficacy. Tissuepatch could be used in open fetal surgery to prevent iPPROM.