The present study investigated two novel biophotopolymer classes that are chemically based on non-toxic poly (vinyl alcohol). These vinylesters and vinylcarbonates were compared to standard acrylates in vitro on MC3T3-E1 cells and in vivo in a small animal model. In vitro, both vinylester and vinylcarbonate monomers showed about tenfold less cytotoxicity when compared to acrylates (IC50: 2.922 mM and 2.392 mM vs. 0.201 mM) and at least threefold higher alkaline phosphatase activity (17.038 and 18.836 vs. 5.795, measured at [10 mM]). In vivo, polymerized 3D cellular structures were implanted into the distal femoral condyle of 16 New Zealand White Rabbits and were observed for periods from 4 to 12 weeks. New bone formation and bone to implant contact was evaluated by histomorphometry at end of observation. Vinylesters showed similar rates of new bone formation but significantly less (p = 0.002) bone to implant contact, when compared to acrylates. In contrast, the implantation of vinylcarbonate based biophotopolymers led to significantly higher rates of newly formed bone (p < 0.001) and bone to implant contact (p < 0.001). Additionally, distinct signs of polymer degradation could be observed in vinylesters and vinylcarbonates by histology. We conclude, that vinylesters and vinylcarbonates are promising new biophotopolymers, that outmatch available poly(lactic acid) and (meth)acrylate based materials.

Human vital AM was highly effective in reducing adhesions to polypropylene mesh and sutures in experimental IPOM. No adverse effects were detected, and tissue integration of the mesh was good.

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The fibrin sealant adhesive showed very good overall results of the primary and secondary outcome parameters. FS is a recommendable atraumatic fixation tool for the surgical onlay technique. AGG provides high adhesive strength, but shows low biocompatibility. Persisting active inflammation was seen in both the O-AGG and I-AGG groups, not favoring its use for these indications.

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Zusammenfassung. Grundlagen: Die Art der Fibrinkleber (FS)-Applikation trägt wesentlich zu den Vorzü gen dieser Methode, um Herniennetze zu fixieren, bei. Obwohl in zahlreichen Studien belegt werden konnte, dass die punktförmige Applikation von FS ausreichende Festigkeiten und Elastizität gewährleistet, erschien die Sprayapplikation von FS als wesentliche Verbesserung. Diese Studie sollte die Sicherheit und den Anwendungskomfort eines neuartigen FS-Spraysystems mit abgewinkeltem Sprü hkopf in einer 1-jährigen klinischen Anwendungsbeobachtung testen.Methodik: Nachdem die schriftliche Zustimmung eingeholt wurde, wurden bei 27 Patienten 33 primäre Leistenhernien in TAPP-Technik versorgt. Das makroporöse TiMesh (GfE, Deutschland) wurde mit 2 ml FS (Tissucol + ) mittels eines neuartigen Spraysystems mit abgewinkeltem Sprü hkopf fixiert. Der Sprü hkatheter kann ü ber einen 5 mm-Trokar eingefü hrt werden und verfü gt ü ber eine separate CO 2 -Zufuhr. Der Beobachtungszeitraum war 1 Jahr.Ergebnisse: Die Bedienung des Spraysystems war einfach und ergonomisch zufriedenstellend, und es wurden keine Komplikationen im Zusammenhang mit dessen Anwendung beobachtet. Der Sprü hkegel des FS war gut sichtbar, und es wurden keine Serome gefunden. Die Patienten entwickelten keinen chronischen Schmerz, und es kam innerhalb des einen Jahres zu keinem Rezidiv. 2 ml fü r unilaterale bzw. 4 ml FS fü r bilaterale Hernien waren ausreichend.Schlussfolgerungen: Das neuartige Spraysystem mit abgewinkeltem Sprü hkopf stellt eine klare Verbesserung gegenü ber den bisher erhältlichen Fixationsmethoden dar. Die Anwendung ist einfach und ermöglicht eine erhebliche Reduktion der zur Netzfixation notwendigen FS-Menge. Eine Reduktion der Rate der Serome sowie eine Kostensenkung erscheinen so möglich.Summary. Background: The method of fibrin sealant (FS) application for hernia mesh fixation is essential to obtain its full benefits and advantages (i.e., the reduction of chronic pain). In several studies on hernioplasty, punctual mesh fixation with FS proved to be efficient in terms of fixation strength and elasticity and it was hypothesized that an angled tip laparoscopic spray system (LSS) would improve and facilitate the application of the sealant. The aim of the study was to examine the safety and handling of LSS as well as the one-year outcome.Methods: After informed written consent was obtained, transabdominal preperitoneal hernioplasty (TAPP) was performed in 33 primary inguinal hernias in 27 non-selected consecutive patients by a single surgeon. A macroporous mesh (TI-Mesh + , GfE, Germany) was fixed with 2 ml of FS composed of 1 ml of fibrinogen and 1 ml of thrombin (Tisseel + ¼ Tissucol + ). The FS was applied using a newly developed angled spray catheter insertable through a 5 mm trocar and attached to a CO 2 regulator device. Patients were followed up for one year.Results: The angled tip allowed targeted distribution of FS by minimal movements of the device and was safe. The spray cone was always clearly visible during application. At 3 and 12...