Tissue integration and tolerance to meshes used in gynecologic surgery: An experimental study

Boulanger, L.; Boukerrou, Malik; Lambaudie, Éric; Défossez, A.; Cosson, Michel

doi:10.1016/j.ejogrb.2005.07.029

Cited by 51 publications

(39 citation statements)

References 25 publications

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“…Collagen appears and organizes itself to include the mesh and reinforce the meshtissue cohesion [12]. The kinetics of this inclusion showed, in our study of a rat model, maximal reinforcement around the 25th day.…”

Section: Discussionmentioning

confidence: 73%

Tissue resistance of the tension-free procedure: What about healing?

et al. 2007

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The aim of our work was to objectify and quantify the mechanical benefits of healing with regards to tearing meshes off of tissues and maximal resistance after cicatrization. In vivo, we tested the mechanical gain in resistance by healing after implantation of a Prolene mesh. We measured the value of forces when traction was exerted until mobilization at different stages of cicatrization. Resistance increased progressively at the beginning of tissue inclusion. A maximal plateau was reached around the 25th day. It is important to understand the role of sustaining and reinforcement we hope tissue integration of the mesh will play. We can thus adapt procedures to have the best kinetics and maximal resistance of montages. Study of the kinetics and maximal plateau allows us to make the best clinical recommendations.

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Section: Discussionmentioning

confidence: 73%

Tissue resistance of the tension-free procedure: What about healing?

et al. 2007

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“…Among the various synthetic meshes that were compared intra-abdominally, the monofilament PPL was so far the best, according to integration and compatibility, compared with polyglactin, co-polyglactin-polypropylene or multifilament PPL [26]. The superiority of PPL, with significantly less intestinal complications and infections, was proposed after reports from the Food and Drug Administration on major mesh-related complications after hernia repair [27].…”

Section: Discussionmentioning

confidence: 99%

Long-lasting bioresorbable poly(lactic acid) (PLA94) mesh: a new approach for soft tissue reinforcement based on an experimental pilot study

et al. 2007

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The purpose of this study was to evaluate host response and soft-tissue regeneration after poly(lactic acid) (PLA) mesh implantation in a rat model, in comparison with light-weight polypropylene (PPL) and poly(glycolic acid) (PGA) meshes. Full-thickness abdominal wall defects were created in 45 Wistar rats and reconstructed with 15 PLA(94), 15 PPL and 15 PGA meshes. Animals were killed on days 7, 30 and 90 to evaluate the presence of adhesions and changes in tensile strength of the implants. Histopathology and immunohistochemistry were performed to evaluate the collagen deposition and the inflammatory response. Statistics were done using unpaired Student's t-test, Mann-Whitney rank sum test, Student-Newman-Keuls test and Bonferroni (Dunn) t-test. The inflammatory response induced by the PLA mesh implantation was significantly milder than after PPL mesh. In PLA, vascularity and collagen organization was significantly higher than in PPL and PGA at 30 and 90 days, and collagen composition score was significantly higher than in PPL at 7 and 30 days. In PLA, shrinkage was significantly lower than in PPL and PGA at 7 and 30 days. Elongation at break and tensile strength were comparable between PLA and PPL over the 90-day period. The PLA mesh induces a milder inflammatory response, more orderly collagen deposition than PPL, and preserved comparable tensile strength after 90 days.

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“…No complications were diagnosed at short term. The low risk of infection, as well as the low risk of fistula formation, is attributable to the inherent characteristics and tolerance of the polypropylene mesh [7,14,15]. Certainly, we may have underestimated the number of preoperative bladder injuries.…”

Section: Discussionmentioning

confidence: 99%

Prosthetic reinforcements: how to manage bladder injuries?

Popovic

Debodinance²,

Cosson

et al. 2007

Int Urogynecol J

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The aim of this study was to describe our experience in the management of bladder injuries occurring at intervesicovaginal dissection during the tension-free vaginal mesh (TVM) procedure. Seven hundred four patients were treated for prolapse by vaginal route using the TVM procedure. Bladder injury was diagnosed during the procedure in five patients. Polypropylene mesh was placed in the intervesicovaginal space after a careful repair of the bladder injury. Major postoperative complications were not diagnosed during the short-term follow up. We describe the occurrence and treatment of bladder injuries during the dissection phase in the TVM procedure. Such injuries can occur during the dissection. Placing an intervesicovaginal mesh is acceptable if cautious bladder repair is performed.

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Tissue integration and tolerance to meshes used in gynecologic surgery: An experimental study

Cited by 51 publications

References 25 publications

Tissue resistance of the tension-free procedure: What about healing?

Tissue resistance of the tension-free procedure: What about healing?

Long-lasting bioresorbable poly(lactic acid) (PLA94) mesh: a new approach for soft tissue reinforcement based on an experimental pilot study

Prosthetic reinforcements: how to manage bladder injuries?

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