Abdominal Wall Defects

Langer, Jacob C.

doi:10.1007/s00268-002-6746-1

Cited by 43 publications

(24 citation statements)

References 79 publications

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“…Among others PPP, polytetrafluoroethylene (PTFE), PTFE plus hyaluronic acid, polyester and/ or polyglycolic acid [7,8] are commonly used for this purpose and therefore were selected for this study. ous fistulae, herniae and mesh extrusion are common problems in the use of PPP [1][2][3][4][5][7][8][9]. Only one animal developed a post-operative hernia in this study.…”

Section: Discussionmentioning

confidence: 95%

“…Gastroschisis occurs in one out of 10,000 live births and omphalocele in one out of 4,000-7,000 live births [1][2][3][4]. Several techniques for treating such abdominal wall defects have been described including open abdominal packing, rotation of muscle or fascial flaps and the use of prosthetic materials to bridge the fascial defect [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Meshes of synthetic non-absorbable materials [such as polyester, polypropylene (PPP), polytetraflouroethylene (PTFE, GoreTex), silicone or Dacron], synthetic resorbable materials (polyglycolic acid) and composite materials (PTFE/ polypropylene, silastic) have been used. Currently, one of the most widely used synthetic materials for this purpose is PTFE [1][2][3][4][5]. However, several difficulties are associated with this material, including poor fluid permeability, variability in the formation of the connective tissue, development of visceral adhesions and enteric fistula.…”

Section: Introductionmentioning

confidence: 99%

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A new biocompatible material (Lyoplant®) for the therapy of congenital abdominal wall defects: first experimental results in rats

Meyer¹,

Schwarz

Ulrichs

et al. 2006

Ped Surgery Int

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Congenital abdominal wall defects are impressive and dramatic malformations. Common surgical therapy for omphalocele and gastroschisis is to place the herniated viscera back into the abdomen and to close the fascia. Small defects can be closed directly by surgical treatment. In large defects, resorbable and non-resorbable artificial materials are necessary to close the fascia. The aim of this study is to find out whether new biocompatible materials might be suitable for the treatment of such abdominal wall defects. A median laparotomy was performed in young Wistar rats with a body weight of 75-100 g. Then a full thickness defect was created by excising a 1.5 x 2.5 cm segment including fascia, muscles and peritoneum. These defects were then closed by implantation of a PTFE mesh (Dual-Mesh, n = 6), a PPP mesh (Prolene, n = 6) or a new biocompatible mesh (NBM; Lyoplant, n = 6). Each rat was examined daily after treatment. Bodyweight was determined and the possible development of a hernia was monitored. After 6 weeks, the abdomen was opened again. Adhesions to the intestine were measured and the abdominal wall was removed for histological and tensiometric examination. (1) Compared to the untreated controls, all animals showed physiologic growth and normal bodyweight curve. (2) Only in one rat (Prolene) did an abdominal hernia develop. (3) In contrast to PTFE and PPP mesh, NBM showed only minimal adhesion to the intestine. (4) Tensiometry revealed high stability for non-resorbable materials. However, the characteristics of NBM were very similar to untreated abdominal wall. Our initial results indicate that biocompatible materials can also be used for the therapy of congenital abdominal wall defects.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A new biocompatible material (Lyoplant®) for the therapy of congenital abdominal wall defects: first experimental results in rats

Meyer¹,

Schwarz

Ulrichs

et al. 2006

Ped Surgery Int

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“…In der Therapie der großen kongenitalen Bauchwanddefekte sind neben einer Vielzahl von synthetischen Materialien, wie Polypropylen (PPP), Polytretraflourethylen (PTFE), einer Kombination von PTFE und Hyaluronsäure, Polyester und Polyglykolsäure [5,6,9,12,14,15,17], auch biologische Materialien, wie lyophylisierte Dura [4,20,21], porzine intestinale Submukosa [3,7] Vor allem die nichtresorbierbaren Materialien, wie PPP und PTFE, neigen aufgrund ihrer Materialeigenschaften zur Schrumpfung, welches wiederum die Bildung einer Hernie begünstigen kann. Obwohl wir in unserem Kleintiermodell in einem Fall (PPP-Gruppe) eine Narbenhernie fanden, ist dies wohl eher auf ein technisches Problem als auf eine ungenügende Materialeigenschaft zurückzu-führen, da PPP-Netze seit vielen Jahren erfolgreich in der Hernienchirurgie des adulten Patienten eingesetzt werden.…”

Section: Diskussionunclassified

PAUL-Procedure

Meyer

Seifert

Meyer

et al. 2009

Chirurg

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Treatment of small congenital abdominal wall defects (e.g. omphalocele and gastroschisis) can be performed by direct closure. In large defects non-resorbable artificial materials (e.g. Gore-Tex) are necessary to close the fascia. The aim of this study was to find out whether a new procedure, the PAUL pocedure, might be suitable for the treatment of large abdominal wall defects. A full thickness abdominal wall defect was created in young Wistar Rats. These defects were then closed by implantation of a 1x2 cm sized piece of PTFE (Dual-Mesh), a polypropylene mesh (Prolene(R)) or by using the PAUL procedure. Over a period of 6 weeks no wound infections or hernias were monitored. In contrast to PTFE the PAUL procedure showed only minimal adhesion to the intestine and a high stability of the implanted material. A xenogenic extracellular matrix, such as that used in the PAUL procedure, may induce an immune response, which is comparable with a remodeling reaction rather than rejection. Based on these good results a large animal model study (Goettinger mini-piglets) was performed. No wound infections or hernias could be observed throughout the experiment. Control laparoscopy after 3, 6, 9, and 12 months showed only minimal adhesion to the intestine. Our results indicate that the PAUL procedure can be used easily and successfully for the therapy of congenital abdominal wall defects.

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“…Exomphalos (omphalocele) is the commonest abdominal wall abnormality, and is differentiated from gastroschisis by the presence of a transparent membrane incorporating the amnion and the peritoneum, creating the omphalocele sac [4] . Chromosomal and cardiac abnormalities are much more common in exomphalos (40%) in contrast to other forms of anterior abdominal wall defects [2,5,6] .…”

Section: Introductionmentioning

confidence: 99%

Outcome of Antenatally Diagnosed Fetal Anterior Abdominal Wall Defects from a Single Tertiary Centre

et al. 2008

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Objective: The aim of this study was to review the outcome of all cases of antenatally diagnosed anterior abdominal wall defects at a single tertiary centre. Method: 41 cases from the database of the Centre of Fetal Care at Queen Charlotte’s and Chelsea Hospital in London from 2000 to 2005 were reviewed and both obstetric and neonatal data were collected. Results: 25 cases were exomphalos (61%), 9 were gastroschisis (22%), 6 were body stalk anomaly (15%) and 1 case was cloacal exstrophy (2%). 17 cases (41%) were associated with other major malformations and 4 (10%) were aneuploid. There was 1 case of intrauterine death (2%). Termination of pregnancy was performed in 24 cases (63%). Of the cases that continued (exomphalos and gastroschisis), all babies survived surgery and were discharged home. Conclusions: This study demonstrates a high termination rate for fetuses diagnosed with anterior abdominal wall defects. However, the surgical outcome for euploid neonates with isolated exomphalos or gastroschisis appears to be good. Babies with gastroschisis required a longer period of parenteral feeding compared with babies with exomphalos. These infants however had a longer duration of hospitalization.

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Abdominal Wall Defects

Cited by 43 publications

References 79 publications

A new biocompatible material (Lyoplant®) for the therapy of congenital abdominal wall defects: first experimental results in rats

A new biocompatible material (Lyoplant®) for the therapy of congenital abdominal wall defects: first experimental results in rats

PAUL-Procedure

Outcome of Antenatally Diagnosed Fetal Anterior Abdominal Wall Defects from a Single Tertiary Centre

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