Surgical mesh for ventral incisional hernia repairs:Understanding mesh design

Rastegarpour, Ali; Cheung, Michael C.; Vardhan, Madhurima

doi:10.4172/plastic-surgery.1000955

Cited by 25 publications

(14 citation statements)

References 128 publications

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“…The inflammatory response induced by implantation into the abdominal wall of these prostheses is associated with a minimal adhesive process in the area of polyvinylidene fluoride-based material introduction and more pronounced in the area of polypropylene prostheses. Undoubtedly, the development of implants with such properties is important for the needs of herniologists [4,13].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of postoperative ventral hernias after laparotomy, according to various authors, is from 10% to 30% [1]. According to many researchers, a special place is occupied by defects of large and giant size, involving two or more sections of the abdominal wall, make up 18-45% [9,13]. Of particular concern to surgeons is the degree of destruction of the anatomical structures of the abdominal wall, which can be considered a real '' catastrophe '' when conducting reconstructive operations.…”

Section: Introductionmentioning

confidence: 99%

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Morphological changes of a great omentum at implantation of polypropylene and composite prostheses at allohernioplasty

2019

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To date, allohernioplasty of giant postoperative ventral hernias retains high postoperative mortality and a significant number of postoperative complications. The purpose of the study is to investigate the possibility of intraperitoneal use of polypropylene and composite implants in allohernioplasty of postoperative giant ventral hernias by studying the morphological changes of the great omentum. The results of surgical treatment of 146 patients with postoperative giant ventral hernias were investigated. To this group of patients with allohernioplasty by the method onlay was performed 22 (15.1%) patients, by the method sublay – 46 (31.5%), by the method inlay – 52 (35.6%), with intra-abdominal placement of the mesh by the method onlay (intraperitoneal onlay mesh) – 26 (17.8%). 32 (21.9%) patients who underwent surgery using the sublay method polypropylene implant was fenced off from the abdominal organs with a great omentum, 22 (15.1%) patients operated on by the intraperitoneal onlay mesh method composite implant was also fenced off from the abdominal organs by a great omentum. In 8 (5.5%) patients from the group of patients who were operated on by the sublay method and in 6 (4.1%) – operated by the intraperitoneal onlay mesh method for 14-18 days patients developed signs of chronic intestinal obstruction, where the cause was postoperative adhesive illness. The study of the effect of polypropylene prosthesis on a great omentum was performed on 8 outbred dogs and 6 outbred mature dogs, who were implanted with a composite mesh unilaterally covered with oxycellulose. The polypropylene implant has been shown to have a greater capacity for the development of adhesive processes. However, if a great omentum to protect this prosthesis from the abdominal cavity then the first zone (active inflammation) spread in 155 microns (increase in the number of blood capillaries of the microcirculatory bed, thickening of the arterioles wall, venous full blood flow, diapedesis of leukocytes through the wall of the blood cells), the second zone (sclerosis) – up to 40 microns (increase in the number of macrophages and lymphocytes. proliferation of fibroblasts). In the future, the structure of the omentum was almost indistinguishable, so with allohernioplasty by the developed method, it was possible to prevent the development of adhesive disease on the intestine. This study confirmed the limited spread of the inflammatory response, which allows the implant of a polypropylene mesh on a great omentum. In the composite mesh, the composite mesh was spliced with surrounding tissues from the side where there was no gel coating, and from the side of the salivary coating, the “readiness” to spread the inflammatory process (vasculitis with pronounced lympho-plasmocytic infiltration of the vessel walls and perivascular ductus), therefore, left it is also necessary to enclose it with a large omentum from intestium.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Morphological changes of a great omentum at implantation of polypropylene and composite prostheses at allohernioplasty

2019

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“…The probabilities of recurrences and chronical pains can be diminished by correctly tailoring the mechanical properties and resorption times of the implant . Currently, available bioresorbable meshes have a resorption time inferior to 6 months . Medical devices with longer resorption times could also be of interest because the prevalence of implant infections can be decreased using antibacterial materials.…”

Section: Introductionmentioning

confidence: 99%

“…2 Currently, available bioresorbable meshes have a resorption time inferior to 6 months. 3 Medical devices with longer resorption times could also be of interest because the prevalence of implant infections can be decreased using antibacterial materials. Regarding the biomedical knitted fabrics, the use of monofilaments is to be preferred over multifilaments which provide interstices where bacteria can hide from the immune system.…”

Section: Introductionmentioning

confidence: 99%

Cytocompatibility / Antibacterial Activity Trade-off for Knittable Wet-Spun Chitosan Monofilaments Functionalized by the In Situ Incorporation of Cu²⁺ and Zn²⁺

Passieux

Sudre

Montembault

et al. 2022

ACS Biomater. Sci. Eng.

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The wet spinning of cytocompatible, bioresorbable, and knittable chitosan (CTS) monofilaments would be advantageous for a variety of surgical applications. The complexation capacity of chitosan with Cu 2+ or Zn 2+ can be leveraged to enhance its antibacterial activity, but not at the expense of cytocompatibility. In this work, a wet-spinning process was adapted for the in situ incorporation of Cu 2+ or Zn 2+ with chitosan dopes to produce monofilaments at different drawing ratios (τ tot ) with various cation/glucosamine molar ratios, evaluated in the fibers (r Cu,f and r Zn,f ). Cytocompatibility and antibacterial activity of wet-spun monofilaments were, respectively, quantified by in vitro live-dead assays on balb 3T3 and by different evaluations of the proliferation inhibition of Staphylococcus epidermidis (Gram+) and Escherichia coli (Gram−). Knittability was tested by a specific tensile test using a knitting needle and evaluated with an industrial knitting machine. It was found that r Cu,f = 0.01 and r Zn,f = 0.03 significantly increase the antibacterial activity without compromising cytocompatibility. Wet spinning with τ tot = 1.6 allowed the production of knittable CTS-Cu monofilaments, as confirmed by knitting assays under industrial conditions.

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“…On the other hand, the improvement in surgical meshes has been focused on identifying and making use of the most appropriate material. More than 200 types of meshes were reported in 2013 (Klinge et al, 2013); these meshes have different mechanical properties, pore sizes, weight, density, constitution (monofilament or twisted), manufacturing processes (extrusion or knitting), anisotropy, and type of material (synthetic non-absorbable, mixed or composite, and biological) (Rastegarpour et al, 2016). Moreover, many biocompatible coatings have been developed to modify surgical mesh surfaces and are aimed at protecting the prosthesis from degradation, decreasing postsurgical inflammation, minimizing foreign body reaction, reducing the risk of infections, and decreasing adhesions (Majumder et al, 2015;Bayloń et al, 2017;Bredikhin et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model

et al. 2020

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Surgical mesh for ventral incisional hernia repairs:Understanding mesh design

Cited by 25 publications

References 128 publications

Morphological changes of a great omentum at implantation of polypropylene and composite prostheses at allohernioplasty

Morphological changes of a great omentum at implantation of polypropylene and composite prostheses at allohernioplasty

Cytocompatibility / Antibacterial Activity Trade-off for Knittable Wet-Spun Chitosan Monofilaments Functionalized by the In Situ Incorporation of Cu²⁺ and Zn²⁺

Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model

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Surgical mesh for ventral incisional hernia repairs:Understanding mesh design

Cited by 25 publications

References 128 publications

Morphological changes of a great omentum at implantation of polypropylene and composite prostheses at allohernioplasty

Morphological changes of a great omentum at implantation of polypropylene and composite prostheses at allohernioplasty

Cytocompatibility / Antibacterial Activity Trade-off for Knittable Wet-Spun Chitosan Monofilaments Functionalized by the In Situ Incorporation of Cu2+ and Zn2+

Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model

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Cytocompatibility / Antibacterial Activity Trade-off for Knittable Wet-Spun Chitosan Monofilaments Functionalized by the In Situ Incorporation of Cu²⁺ and Zn²⁺