Biomaterials for Pelvic Floor Reconstructive Surgery: How Can We Do Better?

Table 2

Autologous fascia.

Author	Sample	Biomechanical properties	Host response
FitzGerald et al., 2000 [23]	Autologous rectus fascia implanted in 5 patients suffering from SUI. Samples obtained, respectively, from transvaginal revision after 3, 5, 8, and 17 weeks and from replacement after 4 years.		(i) Moderate and uniform infiltration of host fibroblasts and neovascularization after 5 and 8 weeks of implantation.; (ii) After 4 years of implantation, no evidence of inflammatory cell infiltrate or foreign body reaction and collagen remodeling by connective tissue organized longitudinally.
Jeong et al., 2000 [24]	Autologous lata fascia implanted in 16 rabbits randomized into 4 survival groups and examined after 1, 2, 4, and 8 weeks. Implantation into upper eyelids.		(i) Low inflammatory cell infiltration.; (ii) Fibroblast infiltration and collagen remodeling.
Choe et al., 2001 [21]	Dermis, rectus fascia, and vaginal mucosa harvested from 20 women undergoing vagina prolapse surgery.	Tensiometric analysis of full strips versus patch suture slings. Displacement and maximum load calculated.
Kim et al., 2001 [22]	Autologous rectus fascia implanted in 20 rats randomized into 2 survival groups (2 and 4 months).	No significant decrease of the fracture toughness calculated by the trouser tear test over 4 months.
Dora et al., 2004 [19]	Autologous rectus fascia implanted in 15 rabbits randomized into 3 survival groups (2, 6, and 12 weeks). Implantation on the anterior rectus fascia.	No significant decrease of biomechanical properties after 12 weeks of implantation.	50% decrease in surface area.
Hilger et al., 2006 [20]	Autologous rectus fascia implanted in 20 rabbits randomized into 2 survival groups (6 and 12 weeks). Half implanted on the rectus fascia and half on the posterior vagina fascia.	No significant decrease of biomechanical properties after 12 weeks of implantation.	(i) Collagen remodeling by moderate collagen infiltration but encapsulation as well.; (ii) Minimal inflammatory response.; (iii) Minimal neovascularization.
Krambeck et al., 2006 [26]	Autologous rectus fascia implanted subcutaneously on the anterior rectus fascia of 10 rabbits randomized into 2 survival groups (6 and 12 weeks).		(i) Moderate fibrosis.; (ii) High degree of scarring.; (iii) High degree of inflammatory infiltrate.
de Almeida et al., 2007 [29]	Adult female rats incontinence model. Marlex, autologous sling, SIS, polypropylene mesh, and sham at 30 and 60 days.		Reduced inflammatory response and collagen production around autologous grafts, in comparison with synthetic materials and xenografts.
Woodruff et al., 2008 [27]	Autologous fascia grafts explanted after sling revision from 5 women, due to different complications, between 2 and 65 months after implantation.		(i) Moderate and uniform infiltration of host fibroblasts and little neovascularization.; (ii) Collagen remodeling by new collagen fibers organized longitudinally.; (iii) No evidence of encapsulation or gross infection.
de Rezende Pinna et al., 2011 [28]	Autologous fascia lata implanted in 14 rabbits randomized into 2 survival groups (30 and 60 days). Implantation into the right voice muscle.		(i) No significant inflammatory reaction.; (ii) No significant fibrosis or scarring.