Biomaterials for abdominal wall hernia surgery and principles of their applications

Amid, Parviz K.; Shulman, Alex G.; Lichtenstein, Irving L.; M, Hakakha

doi:10.1007/bf00680113

Cited by 171 publications

(126 citation statements)

References 16 publications

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“…Tissue reactions to different types of synthetic materials used to repair the defects of the pelvic floor are almost established and have not been dealt with in this study (22)(23)(24)(25). It is known that, apart from the mechanical properties of the implanted material, local factors such as tissue tropism, infections and the surgical technique are directly related to the rates of extrusion (26,27).…”

Section: Discussionmentioning

confidence: 99%

Primary fixation of mini slings: a comparative biomechanical study in vivo

Palma

Siniscalchi²,

Maciel³

et al. 2012

Int. braz j urol.

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Section: Discussionmentioning

confidence: 99%

Primary fixation of mini slings: a comparative biomechanical study in vivo

Palma

Siniscalchi²,

Maciel³

et al. 2012

Int. braz j urol.

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“…A variety of materials have been used as biomaterials for fascial repair, including synthetic implants and naturally derived tissue matrices [1][2][3][4][5]. An ideal biomaterial for fascial tissue repair should be biocompatible, promote new tissue formation, elicit minimal inflammation and be able to withstand sufficient tensile forces in order to maintain structural integrity in vivo [2,3,6].…”

Section: Introductionmentioning

confidence: 99%

“…An ideal biomaterial for fascial tissue repair should be biocompatible, promote new tissue formation, elicit minimal inflammation and be able to withstand sufficient tensile forces in order to maintain structural integrity in vivo [2,3,6]. Although synthetic materials, such as polypropylene mesh, have been used to match the required tensile strength for fascial tissue substitute, these materials are frequently associated with untoward effects such as fibrotic encapsulation, infection, erosion, bowel adhesion and mesh extrusion [7-11, 4, 12-14].…”

Section: Introductionmentioning

confidence: 99%

One and four layer acellular bladder matrix for fascial tissue reconstruction

Eberli

Atala

Yoo

2011

J Mater Sci: Mater Med

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To determine whether the use of multiple layers of acellular bladder matrix (ABM) is more suitable for the treatment of abdominal wall hernia than a single layered ABM. The feasibility, biocompatibility and mechanical properties of both materials were assessed and compared. Biocompatibility testing was performed on 4 and 1 layered ABM. The matrices were used to repair an abdominal hernia model in 24 rabbits. The animals were followed for up to 3 months. Immediately after euthanasia, the implant site was inspected and samples were retrieved for histology, scanning electron microscopy and biomechanical studies. Both acellular biomaterials demonstrated excellent biocompatibility. At the time of retrieval, there was no evidence of infection. The matrices demonstrated biomechanical properties comparable to native tissue. Three hernias (25%) were found in the single layer ABM group and only 1 hernia (8%) was found in the 4 layer ABM group. Histologically, the matrix structure was intact and the cell density within the matrices decreased with time. The dominant cell type present within the matrices shifted from lymphocytes to fibroblasts over time. Both ABMs maintained adequate strength over time when used for hernia repair, and there was an extremely low incidence of adhesion formation. The single layer ABM showed enhanced cellular integration, while the 4 layer ABM reduced hernia formation. Either of these matrices may be useful as an off-the-shelf biomaterial for patients requiring fascial repair. TITLE:ONE To determine whether the use of multiple layers of acellular bladder matrix (ABM) is more suitable for the treatment of abdominal wall hernia than a single layered ABM. The feasibility, biocompatibility and mechanical properties of both materials were assessed and compared.Design and Method: Biocompatibility testing was performed on 4 and 1 layered ABM.The matrices were used to repair an abdominal hernia model in 24 rabbits. The animals were followed for up to 3 months. Immediately after euthanasia, the implant site was inspected and samples were retrieved for histology, scanning electron microscopy and biomechanical studies.Results: Both acellular biomaterials demonstrated excellent biocompatibility. At the time of retrieval, there was no evidence of infection. The matrices demonstrated biomechanical properties comparable to native tissue. Three hernias (25%) were found in the single layer ABM group and only 1 hernia (8%) was found in the 4 layer ABM group.Histologically, the matrix structure was intact and the cell density within the matrices decreased with time. The dominant cell type present within the matrices shifted from lymphocytes to fibroblasts over time.

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“…The use of polypropylene mesh in hernia surgery has become increasingly popular. The use of synthetic mesh for achieving a tension free repair has resulted in a significant reduction in postoperative recurrences 4 . Polypropylene meshes have a mild reactivity upon implantation, in-growth, tensile strength which is retained for indefinite periods of time and a low susceptibility to mesh infection 5 , but, they can induce adhesion of viscera when placed intraperitoneally 6 .…”

mentioning

confidence: 99%

Inguinal hernias in patients of 50 years and above. Pattern and outcome

Shyam

Rapsang

2013

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTObjective: Objective: Objective: Objective: Objective: to evaluate a one year experience with inguinal hernia repair, in patients of > 50years, with respect to the type of inguinal hernia, type of surgery, postoperative complications and recurrence. Methods:Methods: Methods: Methods: Methods: a prospective descriptive study of patients (n=57) > 50 years operated for inguinal hernia during a one year period. Tension-free meshplasty and herniorrhaphy, using 3"x6" polypropylene mesh and 2-0 polypropylene suture, were performed in elective and emergency surgery respectively. Follow-up visits were scheduled at six weeks, three and six months postoperatively. Results:Results: Results: Results: Results: the most representative age group was 61-70 years, and all patients were male. 52 (91.22%) patients had unilateral inguinal hernias, while five (8.77%) had bilateral hernias. In 50 (87.71%) patients, the hernia was uncomplicated, while seven (12.28%) patients presented with some complication such as obstruction or strangulation. Elective surgery was performed in 50 (87.71%) patients while seven (12.28%) patients were operated in emergency. Postoperatively, 50 (87.7%) patients had uneventful recovery, while seven (12.28%) patients developed some complications which were treated conservatively. Mean hospital stay was six days. One recurrence was observed and there was no peri/postoperative death. Conclusion: Conclusion: Conclusion: Conclusion: Conclusion: tension-free meshplasty and herniorrhaphy are safe, simple and applicable even in elderly patients after adequate preoperative assessment and optimization. Although associated with longer hospital stay, the mortality rate is nil and complication as well as recurrence rate is low. Hence, timely repair is necessary in elderly patients even in those with comorbid conditions.

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Biomaterials for abdominal wall hernia surgery and principles of their applications

Cited by 171 publications

References 16 publications

Primary fixation of mini slings: a comparative biomechanical study in vivo

Primary fixation of mini slings: a comparative biomechanical study in vivo

One and four layer acellular bladder matrix for fascial tissue reconstruction

Inguinal hernias in patients of 50 years and above. Pattern and outcome

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