Comparison between polypropylene and polypropylene with poliglecaprone meshes on intraperitoneal adhesion formation

Biondo-Simões, Maria de Lourdes Pessole; Schiel, Wagner Augusto; Arantes, M. S. T.; Silveira, Tatiane da; Robes, Rogério Ribeiro; Tomasich, Flávio Daniel Saavedra

doi:10.1590/0100-69912016006002

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…Telas de diversos materiais estão disponíveis no mercado, no entanto, a de polipropileno se destaca, por preencher a maioria dos critérios de biocompatibilidade. É considerada inerte ao organismo, não alergênica, não carcinogênica, tem resistência às trações mecânicas e é passível de fácil esterilização 66,128,129 . Várias publicações atestaram a segurança do uso de telas sintéticas em cirurgias de emergência, em ambientes contaminados e mesmo infectados, especialmente utilizando tela de polipropileno em posição pré-aponeurótica 64,73,78,135,[137][138][139][140] .…”

Section: Composição Da Telaunclassified

Prevenção de deiscência da aponeurose com uso profilático de tela pré-aponeurótica em laparotomias de emergência: ensaio clínico randomizado

Lima¹

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INTRODUCTION: Emergency laparotomies have a high risk of complication with reports of fascial dehiscence (FD) in up to 14.9% of cases. The use of onlay mesh in the closure of abdominal wall reduces incidence of incisional hernia after elective surgeries without increased morbidity. However, there are no studies demonstrating its benefit in FD prevention and its use is controversial in emergency laparotomies and in contaminated or infected surgeries. OBJECTIVES: To evaluate whether the use of onlay mesh in the closure of the abdominal wall reduces the incidence of FD in patients submitted to emergency laparotomy, as well as the morbidity of its application. METHODS: A randomized clinical trial was conducted at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. Patients at high risk for FD and indication of emergency midline laparotomy were randomized either to the suture group (running suture with polidioxanone thread and 36 mm needle size, aiming to achieve suture-to-wound length ratio of 4:1) or to the prophylactic mesh group (fascial closure as in the suture group, reinforced with polypropylene onlay mesh). High risk was defined according to the adapted Rotterdam preoperative risk model. The surgical team was blinded to the groups during the intraoperative period (randomization occurred only after complete fascial suture). RESULTS: From June 2015 to February 2018, 145 patients were randomized, 30 of whom were excluded (20.7%) because of death or reoperation, not related to the mesh procedure, in the first 30 days; 52 were allocated in the suture group and 63 in the prophylactic mesh group. Both groups were equivalent for demographic data and clinical characteristics, except for age, whose mean was higher in the suture group (66.1 years vs 61.0 years, p = 0.03). Patients were classified as ASA III or IV in 44 (38.3%) cases. Among the operations, 49 (42.6%) were contaminated or infected, 63 (54,8%) involved ostomy formation and 89 (77.4%) were colorectal surgeries. Hospital length of stay (LOS) and intensive care unit LOS were similar. Mean operative time was 50.8 minutes longer in the prophylactic mesh group (p = 0.01). FD occurred in seven cases of the suture group (13.5%) and none in the prophylactic mesh group (p = 0.003). There was no statistical difference between the groups regarding the number of patients with surgical site occurrence (SSO) [15 (28.8%) vs 27 (42.9%), p = 0.12], or surgical site occurrences that required procedural interventions (SSOPI) [9 (17.3%) vs 14 (22.2%), p = 0.51]. However, some SSO were more frequent in the prophylactic mesh group: seroma [3 (5.8%) vs 12 (19.0%), p = 0.03], surgical site infection (SSI) [4 (7, 7%) vs 13 (20.6%), p = 0.05] and superficial wound dehiscence [3 (5.8%) vs 15 (23.8%), p = 0.008)]. Seven cases of the prophylactic mesh group had superficial wound dehiscence with mesh exposure, treated with local dressings and healing by second intention, with complete resolution in less than 90 days. No case required complete removal of mesh. Of ...

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Section: Composição Da Telaunclassified

Prevenção de deiscência da aponeurose com uso profilático de tela pré-aponeurótica em laparotomias de emergência: ensaio clínico randomizado

Lima¹

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Aderências em telas de polipropileno versus telas Sepramesh®: estudo experimental em ratos.

Biondo-Simões

Pessini

Porto

et al. 2018

Rev. Col. Bras. Cir.

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RESUMO Objetivo: comparar a formação de aderências intraperitoneais, induzidas em ratos, quando utilizadas as telas de polipropileno e Sepramesh®. Métodos: foram utilizados 20 ratos Wistar, machos, agrupados randomicamente em dois grupos de dez animais cada. Duas telas de dimensão 10x20mm foram dispostas intraperitonealmente em cada animal, uma de polipropileno (PP) e a outra Sepramesh®. No Grupo 1, a tela de polipropileno foi posicionada à direita e a tela Sepramesh® à esquerda. No Grupo 2, a disposição das telas foi invertida. Após 14 dias do procedimento, os animais foram eutanasiados e a incorporação e a porcentagem de aderências, em cada tela, analisadas macroscopicamente. Os dados coletados foram submetidos à análise estatística com nível de significância adotado de p<0,05. Resultados: todas as telas apresentaram aderências. Nas telas Sepramesh®, a porcentagem de superfície coberta por aderências variou entre 2% e 86%, com média de 18,6±18,6%, enquanto que, nas telas de polipropileno, variou entre 6% e 86%, com média de 57,4%±34,9% (p<0,05). Os sítios preferenciais de formação de aderências, em ambas as telas, foram as bordas. Conclusão: embora nenhuma tela tenha sido capaz de inibir completamente o desenvolvimento de aderências, a tela Sepramesh® apresentou menos aderências em relação à tela de polipropileno. A preferência da formação de aderências nas bordas das próteses evidencia a importância da fixação adequada das telas.

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8-isoprostane as a marker of oxidative stress in experimental animals after implantation of surgical mesh with a coating based on tantalum and its derivatives

NAKONECHNA,

KYSLOV

2023

Eksp.Klin.fiziol.biohim

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Nowadays, the world observes the problem of adhesion process after implantation of polypropylene surgical meshes, which occurs in about 30–40 % of patients in the postoperative period. Over the past 30 years, tantalum and its derivatives have proven themselves as materials for biomedical implants in dentistry and orthopedics. In the future, tantalum-based coatings may become an inhibitor of the development of adhesion and inflammatory processes after surgical mesh implantation. In order to better predict the implantation of biomedical materials, it is important to determine the markers of the development of oxidative stress. A change in the concentration of biomarkers of the state of the oxidants system, in particular 8-isoprostane, can indicate the development of pathological conditions under the conditions of oxidative stress, which can have a significant impact on the viability of cells after surgical intervention. The aim of the study is to determine the concentration of 8-isoprostane in the blood of rats after implantation of surgical meshes coated with tantalum and tantalum oxide. Materials and methods. The experimental group included 36 male rats of the WAG population weighing 240 ± 20 g. A 15x15 mm polypropylene surgical mesh was surgically implanted between the abdominal wall and various sections of the colon. Anesthesia was performed using the intraperitoneal route of administration of the drug «Relax» BioTestLab, Ukraine) at a dose of 8 mg/kg. After 28 days, the experimental animals were decapitated by cervical dislocation, and blood was immediately collected in sterile K2 EDTA VACUTAINER tubes (BD Vacutainer®). Blood samples were used to determine the content of 8-isoprostane in the blood by enzyme-linked immunosorbent assay using the «8-isoprostane EIA KIT» kit (Cayman Chemical Company, USA) according to the manufacturer’s instructions on the «Solar» PV-1251C spectrophotometer. Results and discussion. The content of 8-isoprostane in blood plasma was statistically 158,6 % higher in the experimental group implanted with uncoated surgical mesh and 171,5 % higher in the experimental group implanted with polypropylene surgical mesh with tantalum nitride coating in comparison with the results of the control group. The concentration of 8-isoprostane in the blood of rats after implantation of polypropylene surgical meshes with a coating based on tantalum and tantalum oxide was higher by 102,6 % and 111,1 %, respectively, compared to the results obtained in the group of intact animals, which indicates their better biocompatibility compared to the results of the groups implanted with uncoated and coated tantalum nitride surgical mesh. Conclusion. The obtained results indicate that coatings based on tantalum and tantalum oxide inhibit lipid peroxidation and demonstrate excellent biocompatibility and anti-inflammatory effect, which makes it possible to consider their future use in hernioplasty.

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Comparison between polypropylene and polypropylene with poliglecaprone meshes on intraperitoneal adhesion formation

Cited by 3 publications

References 25 publications

Prevenção de deiscência da aponeurose com uso profilático de tela pré-aponeurótica em laparotomias de emergência: ensaio clínico randomizado

Prevenção de deiscência da aponeurose com uso profilático de tela pré-aponeurótica em laparotomias de emergência: ensaio clínico randomizado

Aderências em telas de polipropileno versus telas Sepramesh®: estudo experimental em ratos.

8-isoprostane as a marker of oxidative stress in experimental animals after implantation of surgical mesh with a coating based on tantalum and its derivatives

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