Which mesh or graft? Prosthetic devices for abdominal wall reconstruction

Abid, Shazia; El‐Hayek, Kevin

doi:10.12968/hmed.2016.77.3.157

Cited by 8 publications

(5 citation statements)

References 30 publications

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“…Reabsorbable and permanent surgical meshes are extensively used in abdominal surgery . Although most available materials are safe and biocompatible, there are common drawbacks associated to the use of inert surgical meshes including infection, fibrosis, inflammatory reaction, and foreign body reaction .…”

Section: Discussionmentioning

confidence: 99%

“…Tensionless repair of abdominal wall defects is one of the major clinical challenges in abdominal surgery, since reconstruction under tension is associated with surgical failure and high recurrence rate . In cases in which native tissue is damaged or absent, it is necessary to use prosthetic materials allowing an effective abdominal wall closure.…”

Section: Introductionmentioning

confidence: 99%

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Generation and Evaluation of Novel Stromal Cell‐Containing Tissue Engineered Artificial Stromas for the Surgical Repair of Abdominal Defects

Martín-Piedra

Garzón

Gómez-Sotelo

et al. 2017

Biotechnology Journal

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Repair of abdominal wall defects is one of the major clinical challenges in abdominal surgery. Most biomaterials are associated to infection and severe complications, making necessary safer and more biocompatible approaches. In the present work, the adequate mechanical properties of synthetic polymer meshes with tissue-engineered matrices containing stromal mesenchymal cells is combined to generate a novel cell-containing tissue-like artificial stroma (SCTLAS) for use in abdominal wall repair. SCTLAS consisting on fibrin-agarose hydrogels seeded with stromal cells and reinforced with commercial surgical meshes (SM) are evaluated in vitro and in vivo in animal models of abdominal wall defect. Inflammatory cells, collagen, and extracellular matrix (ECM) components are analyzed and compared with grafted SM. Use of SCTLAS results in less inflammation and less fibrosis than SM, with most ECM components being very similar to control abdominal wall tissues. Cell migration and ECM remodeling within SCTLAS is comparable to control tissues. The use of SCTLAS could contribute to reduce the side-effects associated to currently available SM and regenerated tissues are more similar to control abdominal wall tissues. Bioengineered SCTLAS could contribute to a safer treatment of abdominal wall defects with higher biocompatibility than currently available SM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Generation and Evaluation of Novel Stromal Cell‐Containing Tissue Engineered Artificial Stromas for the Surgical Repair of Abdominal Defects

Martín-Piedra

Garzón

Gómez-Sotelo

et al. 2017

Biotechnology Journal

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“…As it is well known that an ideal graft should have characteristics such as strong, inert, resistant to infection, low recurrence rate, high quality of life and good value. Ongoing advancements in techniques and technology will continue to help surgeons tailor the graft to the clinical scenario (30). Therefore, it can be concluded that the SGGEP meninges graft is more effective for managing abdominal wall defects than ADM.…”

Section: Discussionmentioning

confidence: 99%

Selective Germline Genome Edited Pig Meninges Grafts for the Abdominal Wall Closure in Damage Control Surgery

Zou

zhang

et al. 2020

Preprint

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Reconstruction of abdominal wall defects is still a big challenge in surgery, especiallywhere there is insufficient fascia muscular or excessive tension of the defects in emergency and life-threatening scenarios. Indeed, the concept of damage control surgery has been advanced in the management of both traumatic and nontraumatic surgical settings. The strategy requires abridged surgery and quick back to intensive care units (ICU) for aggressive resuscitation. In the damage control laparotomy, patients are left with open abdomen or provisional closure of the abdomen with a planned return to the operating room for definitive surgery. So far, various techniques have been utilized to achieve early temporary abdominal closure, but there is no clear consensus on the ideal method or material for abdominal wall reconstruction. We recently successfully created the selective germline genome-edited pig (SGGEP) and here we aimed to explore the feasibility of in vivo reconstruction of the abdominal wall in a rabbit model with SGGEP meninges grafts (SGGEP-MGs). Our result showed that the SGGEP-MGs could restore the integrity of the defect very well. After 7 weeks of engraftment, there was no sign of herniation observed, the grafts were re-vascularized, and the defects were well repaired.Histologically, the boundary between the graft and the host was very well integrated and there was no strong inflammatory response. Therefore, this kind of closure could help restore the fluid and electrolyte balance and to dampen systemic inflammatory response in damge control surgery while ADM graft failed to establish re-vascularization as the same as the SGGEP-MG. It is concluded that the meninges of SGGEP could serve as a high-quality alternative for restoring the integrity of the abdominal wall, especially for damage control surgery.

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“…Absorbable materials, also known as biosynthetic or bioabsorbable, like polyglactin 910 (Vicryl®), polyglycolic acid (Dexon TM ), polyglycolic acid: Trimethylene carbonate (Bio A®) or a copolymer of glycolide lactide and trimethylene carbonate (TIGR®) (Figure 4) [93] were introduced based on the idea that full reabsorption of the material into the patients´tissue would leave no foreign material behind. When the absorbable material is introduced as a barrier, separation is achieved between the implant and viscera until the mesh becomes covered by a neoperitoneum that prevents adhesion formation [94].…”

Section: Absorbable Materialsmentioning

confidence: 99%

Biomaterial Implants in Abdominal Wall Hernia Repair: A Review on the Importance of the Peritoneal Interface

2019

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Biomaterials have long been used to repair defects in the clinical setting, which has led to the development of a wide variety of new materials tailored to specific therapeutic purposes. The efficiency in the repair of the defect and the safety of the different materials employed are determined not only by the nature and structure of their components, but also by the anatomical site where they will be located. Biomaterial implantation into the abdominal cavity in the form of a surgical mesh, such as in the case of abdominal hernia repair, involves the contact between the foreign material and the peritoneum. This review summarizes the different biomaterials currently available in hernia mesh repair and provides insights into a series of peculiarities that must be addressed when designing the optimal mesh to be used in this interface.

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Which mesh or graft? Prosthetic devices for abdominal wall reconstruction

Abstract: This article reviews the ever-increasing number of prosthetic devices--both synthetic mesh and biologic grafts--now in use for abdominal wall reconstruction. It also introduces a novel hybrid synthetic/biologic graft (Zenapro) and suture passer device (Novapass).

Cited by 8 publications

References 30 publications

Generation and Evaluation of Novel Stromal Cell‐Containing Tissue Engineered Artificial Stromas for the Surgical Repair of Abdominal Defects

Generation and Evaluation of Novel Stromal Cell‐Containing Tissue Engineered Artificial Stromas for the Surgical Repair of Abdominal Defects

Selective Germline Genome Edited Pig Meninges Grafts for the Abdominal Wall Closure in Damage Control Surgery

Biomaterial Implants in Abdominal Wall Hernia Repair: A Review on the Importance of the Peritoneal Interface

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