Relationship between Biomaterials Structure Used in Hernia Mesh Fixation and Chronic Infection

Mavrodin, Carmen Iuliana; Antoniac, Vasile Iulian; Pariza, George

doi:10.4028/www.scientific.net/amr.1114.278

AMR

2015

DOI: 10.4028/www.scientific.net/amr.1114.278

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Relationship between Biomaterials Structure Used in Hernia Mesh Fixation and Chronic Infection

Carmen Iuliana Mavrodin

Vasile Iulian Antoniac

George Pariza

Abstract: Broad introduction and development of polymeric materials in abdominal hernia surgery led to the emergence and identification of secondary complications due to interaction between prosthetic material and human tissue. Whether identification of these reactions has led to the placement instructions of the prostheses into the wall structures of adbomen, there is no clear rule on fixation materials of these prosthesis; they generally follow the recommendations of the prosthesis materials.There are some situations … Show more

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2017

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Cited by 3 publications

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“…Although the reinforcement and strengthening of the abdominal tissues to prevent recurrence is the main task of a mesh, functional restrictions can improve the quality of patient life. According to recent studies, many patients with a large mesh within the abdominal tissue express complaints such as physical restriction of abdominal mobility [4][5][6][7][8][9]. Restoring the physiological properties of the abdominal tissue must take into account the interactions of the human structures and the resulting elasticity or tensile strength [2].…”

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confidence: 99%

“…The large variety of biomaterials used in abdominal surgery and the multitude of surgical fixation procedures show that we are still far from the ideal prosthesis [6,7,[10][11][12][13][14][15][16][17]. Their polymeric characteristics involve different conditions of fixation in the parietal region, the host tissue being different; or different surgical procedures involve different properties of the surgical meshes.…”

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confidence: 99%

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Effect of the Sterilization Procedures of Different Surgical Meshes for Abdominal Surgery

Earar¹,

Grădinaru²,

Pariza³

et al. 2017

Rev. Chim.

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The surgical meshes selection, according to the structure and porosity of the biomaterial type and meshes design, is directly dependent on the surgical procedure used and interaction between biomaterial type and abdominal viscera. Surgical mesh must provide sufficient biomechanical strength in order to assure the physiological requirements in order to protect the soft tissue defects. The large variety of biomaterials used in abdominal surgery and the multitude of surgical fixation procedures show that we are still far from the ideal prosthesis. The main objective of this paper is to determine the effect of the sterilization procedures of some surgical meshes, with different design and made of different materials, on their structure and properties of interest. Experimental research was conducted on three types of surgical meshes, different from material and design point of view. Fourier Transform Infrared (FTIR) Spectroscopy was used to evaluate the structural characteristics of the samples. In the evaluation of the surface properties, scanning electron microscopy (SEM) was used for the qualitative assessment of surface morphology and contact angle determinations (CA) to determine the wettability properties. The sterilization process used was chemical sterilization with ethylene oxide, a procedure used by surgeons in clinical practice. According to the experimental research, the negative effects of the sterilization process on surgical meshes used in abdominal surgery are accentuated for the samples sterilized with ethylene oxide for three times, while their sterilization only one cycle does not significantly affect the surface properties and tensile strength of surgical meshes, regardless of the design and material of which they are composed.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Effect of the Sterilization Procedures of Different Surgical Meshes for Abdominal Surgery

Earar¹,

Grădinaru²,

Pariza³

et al. 2017

Rev. Chim.

Self Cite

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Painful Complications after Pelvic Floor Reconstructive Surgery in Transobturator Suburethral Vaginal Slings

Boț

Vlădăreanu

et al. 2017

KEM

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Stress incontinence is a major social and health problem for middle-aged and elderly women, with an increasing prevalence as life expectancy increases. Reconstructive surgery techniques using vaginal mesh slings of polypropylene (synthetic grafts) have diversified in recent years, but at the same time various postoperative complications have been reported, among the frequent ones being pelvic pain, thigh pain and dyspareunia. The pain mechanism is not fully understood, but pathophysiological theories describe the pain as closely related to the structure, density, size and elasticity of the vaginal mesh, and the inflammatory response of the host.

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Properties Analysis of Biological Grafts Used in Pelvic Surgery

Brătilă

Bratila

Comandaşu

et al. 2017

KEM

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Pelvic surgery addresses congenital malformations like Mullerian anomalies, pelvic organ prolapse or after radical intervention, while constructive surgery involves treatment of congenital/iatrogenic absence of organs: uterus or vagina. Intuitively, inert and nondegradable biomaterials appear ideal for this purpose, but surgical reality is that the persistence of a permanent foreign body in the wound has a lot of clinical postoperative disadvantages. This paper aims to discuss the properties of the biologic grafts, detailing the structure of biologic extracellular matrix, the biomechanical properties of biological grafts and the use of extracellular matrix in reconstructive pelvic surgery. A biologic graft used in pelvic surgery is a tridimensional extracellular matrix, acellular and of animal origin. It has as a low risk of transmission of viral and prionic infections and determines reduced inflammatory reaction and a low risk of rejection. The absence of crosslinking facilitates the colonization of the mesh by the host´s cells, thus avoids the foreign body reaction represented by the encapsulation of the mesh by the host. Our experience with clinical use of biological acellular grafts in reconstructive pelvic surgery includes oncoplastic surgery like in cases of vulvar cancer or neovagina reconstruction for Rokintansky syndrome, complications after prolapse surgery treated with polypropylene meshes or relapsing recto-vaginal fistulas. The biomechanical properties evaluated by tensile stress and elastic modulus revealed that biologic grafts with moderate collagen infiltration are the strongest. The degree of cross-linkage influences the rate of degradation and the degree of the inflammatory response triggered by the host organ. Cross-linked collagenous matrices induce little cell infiltration hence there is limited collagen remodeling and graft degradation. On the other hand, in non-cross- linked xenografts cell infiltration is greater with faster degradation rate and collagen production. The decrease in the mechanical strength of the graft materials is related to the lack of collagen infiltration into the material. In conclusion, taking into account the biomechanical properties of biologic grafts, these may be used in reconstructive pelvic surgery and oncoplastic surgery with little complications and good clinical results. They can be attached to large mucosal defects and on potentially septic tissue, they are mechanically resistant and they can be sutured on surrounding healthy tissue.

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Relationship between Biomaterials Structure Used in Hernia Mesh Fixation and Chronic Infection

Cited by 3 publications

References 22 publications

Effect of the Sterilization Procedures of Different Surgical Meshes for Abdominal Surgery

Effect of the Sterilization Procedures of Different Surgical Meshes for Abdominal Surgery

Painful Complications after Pelvic Floor Reconstructive Surgery in Transobturator Suburethral Vaginal Slings

Properties Analysis of Biological Grafts Used in Pelvic Surgery

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