Comparison of three separate antiadhesive barriers for intraperitoneal onlay mesh hernia repair in an experimental model

Gruber-Blum, Simone; Petter-Puchner, Alexander H.; Brand, Jürgen; Fortelny, René H.; Walder, Nadja; Oehlinger, W.; König, Franz; Redl, Heinz

doi:10.1002/bjs.7334

Cited by 45 publications

(43 citation statements)

References 30 publications

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“…Considering hernia surgery, just a limited number of studies are available. Mainly biomaterials used for laparoscopic applications have been coated using this kind of materials to reduce postoperative adhesion formation, with conflicting results [121,155,156]. Murphy et al recently presented a study investigating a series of biodegradable adhesive polymers that are synthetic mimics of mussel adhesive proteins (MAPs), composed of 3,4-dihydroxyphenylalanine (DOPA)-derivatives, polyethylene glycol (PEG) and polycaprolactone (PCL) to strengthen biomaterial fixation.…”

Section: Protection Against Foreign Body Reactionmentioning

confidence: 98%

“…The rationale behind combining a mesh and an absorbable barrier is to separate the implant and viscera until the mesh becomes covered by a neomesothelium that prevents adhesion formation [125]. Many animal studies have compared coated meshes and investigated the effect of separate antiadhesive barriers [121,[126][127][128][129][130][131][132]. The overall results are somewhat conflicting, and no single mesh construction could be identified completely avoiding adhesion formation.…”

Section: Antiadhesive Barriers and Antiadhesive Mesh Coatingmentioning

confidence: 99%

“…polylactic acid, collagen, hyaluronane and carboxymethylcellulose type) [121]. The use of these barriers was first introduced in by Loury and Chevrel, who used an absorbable sheet of polyglactin [122].…”

Section: Antiadhesive Barriers and Antiadhesive Mesh Coatingmentioning

confidence: 99%

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Mesh biocompatibility: effects of cellular inflammation and tissue remodelling

Junge

Binnebösel

Trotha

et al. 2011

Langenbecks Arch Surg

128

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Mesh biocompatibility is basically determined by the foreign body reaction (FBR). In contrast to physiological wound healing and scar formation, the FBR at the host-tissue/biomaterial interface is present for the lifetime of the medical device. The cellular interactions at the mesh/tissue interface proceed over time ending up in a chronic inflammatory process. The time course of the FBR has been studied extensively and consists of three crucial steps that are protein absorption, cell recruitment and, finally, fibrotic encapsulation and extracellular matrix formation. Each of these steps involves a complex cascade of immune modulators including soluble mediators and various cell types. Recent research has focused on the cellular and molecular interactions of the distinct phases of the FBR offering a new basis for therapeutical strategies. The highly dynamic process of the FBR is considerably influenced by the biomaterial composition. Modifications of the type of polymer, the material weight, the filament structure and the pore size are realized and have substantial effects on the in vivo biocompatibility. Moreover, modern mesh technology aims to utilize the available implants as carrier systems for bioactive drugs. Studies in animal models account for the efficiency of these drugs that aim to reduce mesh-related infections or to minimize FBR by influencing inflammation or extracellular matrix remodelling. A thorough understanding of the molecular mechanisms of FBR provides a sophisticated background for the development of new biomaterials at least as carrier systems for bioactive reagents to reduce inflammation and to improve clinical outcome.

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Section: Protection Against Foreign Body Reactionmentioning

confidence: 98%

Section: Antiadhesive Barriers and Antiadhesive Mesh Coatingmentioning

confidence: 99%

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Mesh biocompatibility: effects of cellular inflammation and tissue remodelling

Junge

Binnebösel

Trotha

et al. 2011

Langenbecks Arch Surg

128

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“…There was no infl ammatory reaction, and the extent and density of fi brosis were small. Three types of antiadhesive fi lms (SurgiWrap ® , Prevadh ® , and Seprafi lm ® ) were compared for intraperitoneal onlay mesh hernia repair in a rat model [ 60 ] . Prevadh (Covidien, Mansfi eld, Massachusetts) is made of oxidized bovine atelocollagen type 1, poly(ethylene glycol), and glycerol, which is degraded within 3 weeks.…”

Section: Fig 516mentioning

confidence: 99%

Barriers to Prevent Tissue Adhesion

Suzuki

Ikada

2011

Biomaterials for Surgical Operation

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Adhesion often occurs after surgery, especially in abdominal, gynecological, and thoracic surgeries. It can cause serious postsurgical complications such as infertility, chronic pelvic pain, and diffi culties of extensive adhesiolysis in future surgery. Antiadhesive barriers have been developed to provide physical separation between the injured site and the adjacent tissues. Since physical separation is only required during the critical time of wound healing of the damaged area, bioabsorbable polymers have been found to be appropriate. A range of adhesion barriers are commercially available in the forms of solutions, gels, and sheets. Their characteristics and limitations are discussed in this chapter. Recent investigations are also described on newly developed devices that show promising performance such as ease of handling and more effective reduction of adhesion.

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“…Bard Inc., Warwick, Rhode Island, USA), which minimises the attachment of peritoneal tissue (adhesions) to the prosthesis, as well as visceral erosion. The efficacy of Seprafilm TM in preventing the formation of adhesions has been widely proven, in both experimental [6][7][8] and clinical [9][10][11] studies. Indeed, a Cochrane review published in 2009 [12] concluded that: ''There is evidence that the use of hyaluronic acid/carbomethyl cellulose (HA/CMC) membrane reduces incidence, extent and severity of adhesions in the abdomen.''…”

Section: Introductionmentioning

confidence: 99%