{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:54:53Z","timestamp":1792155293092,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T00:00:00Z","timestamp":1640736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the host\u2010 and biomechanical response to a fully absorbable poly\u20104\u2010hydroxybutyrate (P4HB) scaffold in comparison with the response to polypropylene (PP) mesh.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>In vivo animal experiment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>KU Leuven Center for Surgical Technologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Fourteen parous female Mule sheep.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>P4HB scaffolds were surgically implanted in the posterior vaginal wall of sheep. The comparative PP mesh data were obtained from an identical study protocol performed previously.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Gross necropsy, host response and biomechanical evaluation of explants, and the in vivo P4HB scaffold degradation were evaluated at 60\u2010 and 180\u2010days post\u2010implantation. Data are reported as mean\u00a0\u00b1\u00a0standard deviation (SD) or standard error of the mean (SEM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Gross necropsy revealed no implant\u2010related adverse events using P4HB scaffolds. The tensile stiffness of the P4HB explants increased at 180\u2010days (12.498\u00a0\u00b1\u00a02.66\u00a0N\/mm SEM [<jats:italic>p\u00a0<\/jats:italic>=0.019]) as compared to 60\u2010days (4.585\u00a0\u00b1\u00a01.57\u00a0N\/mm) post\u2010implantation, while P4HB degraded gradually. P4HB scaffolds exhibited excellent tissue integration with dense connective tissue and a moderate initial host response. P4HB scaffolds induced a significantly higher M2\/M1 ratio (1.70\u00a0\u00b1\u00a00.67 SD, score 0\u20134), as compared to PP mesh(0.99\u00a0\u00b1\u00a00.78 SD, score 0\u20134) at 180\u2010days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>P4HB scaffold facilitated a gradual load transfer to vaginal tissue over time. The fully absorbable P4HB scaffold, in comparison to PP mesh, has a favorable host response with comparable load\u2010bearing capacity. If these results are also observed at longer follow\u2010up in\u2010vivo, a clinical study using P4HB for vaginal POP surgery may be warranted to demonstrate efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable Abstract<\/jats:title><jats:p>Degradable vaginal P4HB implant might be a solution for treatment of POP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17040","type":"journal-article","created":{"date-parts":[[2021,12,5]],"date-time":"2021-12-05T11:29:07Z","timestamp":1638703747000},"page":"1039-1049","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Evaluation of the short\u2010term host response and biomechanics of an absorbable poly\u20104\u2010hydroxybutyrate scaffold in a sheep model following vaginal implantation"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0579-3535","authenticated-orcid":false,"given":"Chantal M.","family":"Diedrich","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Center for Reproductive Medicine (AMC) Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7293-8151","authenticated-orcid":false,"given":"Zeliha","family":"Guler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Center for Reproductive Medicine (AMC) Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Hympanova","sequence":"additional","affiliation":[{"name":"Centre for Surgical Technologies Biomedical Sciences Group KU Leuven  Leuven Belgium"},{"name":"Third Faculty of Medicine Institute for the Care of Mother and Child Charles University  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6897-9495","authenticated-orcid":false,"given":"Eva","family":"Vodegel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Center for Reproductive Medicine (AMC) Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Z\u00fcndel","sequence":"additional","affiliation":[{"name":"Institute of Mechanical Systems ETH Zurich  Zurich Switzerland"},{"name":"Swiss Federal Laboratories for Materials Science and Technology EMPA  D\u00fcbendorf Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Mazza","sequence":"additional","affiliation":[{"name":"Institute of Mechanical Systems ETH Zurich  Zurich Switzerland"},{"name":"Swiss Federal Laboratories for Materials Science and Technology EMPA  D\u00fcbendorf Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-945X","authenticated-orcid":false,"given":"Jan","family":"Deprest","sequence":"additional","affiliation":[{"name":"Centre for Surgical Technologies Biomedical Sciences Group KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Paul","family":"Roovers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Center for Reproductive Medicine (AMC) Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2010.02175.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12545"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12085"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2018.07.024"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001703-200210000-00015"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.03.023"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-016-3029-1"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.01.017"},{"key":"e_1_2_11_10_1","volume-title":"Final opinion on the use of meshes in urogynecological surgery","author":"Reinier M","year":"2016"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msec.2020.111702"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192\u2010021\u201004851\u20106"},{"key":"e_1_2_11_13_1","unstructured":"HuismanGW SkralyF MartinDP PeoplesOP.Biological systems for manufacture of polyhydroxyalkanoate polymers containing 4\u2010hydroxyacids. 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