Analytical, occupational and toxicologic aspects of the degradation products of polypropylene plastics.

Frostling, H; Hoff, A; Jacobsson, Sven P.; Pfäffli, Pirkko; Vainiotalo, Sinikka; Zitting, Antti

doi:10.5271/sjweh.2347

Cited by 28 publications

(11 citation statements)

References 4 publications

(5 reference statements)

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“…The load of these visible particles was limited; however we could not test for the presence of smaller particles, not detectable by light microscope, and chemical products of degradation. Outside the body, thermal degradation of polypropylene produces an array of organic molecules such as acids, ketones, ethers, aldehydes, alcohols and smaller hydrocarbons . The conditions of thermal degradation of polypropylene do not match those of degradation in the body; however the results can be used to estimate the range of chemicals that can be potentially produced in the tissue.…”

Section: Discussionmentioning

confidence: 99%

Degradation of polypropylene in vivo: A microscopic analysis of meshes explanted from patients

2015

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Polypropylene meshes, originally introduced for hernia repair, are presently utilized in several anatomical sites. Several million are implanted annually worldwide. Depending on the device, up to 10% will be excised to treat complications. The excised meshes can provide material to study the complications, however, they have remained underutilized over the last decades and the mechanisms of complications continue to be incompletely understood. The fundamental question as to whether polypropylene degrades in vivo is still debated. We have examined 164 excised meshes using conventional microscopy to search for features of polypropylene degradation. Four specimens were also examined by transmission electron microscopy. The degraded material, detected by its ability to absorb dyes in the degradation nanopores, formed a continuous layer at the surface of the mesh fibers. It retained birefringence, inclusions of non-degraded polypropylene, and showed ability to meld with the non-degraded fiber core when heated by the surgical cautery. Several features indicated that the degradation layer formed in vivo: inflammatory cells trapped within fissures, melting caused by cautery of excision surgery, and gradual but progressive growth of the degradation layer while in the body. Cracking of the degraded material indicated a contribution to clinically important mesh stiffening and deformation. Chemical products of degradation need to be analyzed and studied for their role in the mesh-body interactions. The described methods can also be used to study degradation of other materials. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 237-248, 2017.

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Section: Discussionmentioning

confidence: 99%

Degradation of polypropylene in vivo: A microscopic analysis of meshes explanted from patients

2015

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“…As a chain polymer polypropylene has the potential to break down into toxic by‐products including various aldehydes and carboxylic acids. The toxic effect of these by‐products has been demonstrated in a rat study after prolonged exposure, but this study was focused on the industrial use of polypropylene and as such involved subjecting the polymer to extreme temperatures (>250 °C) . At the temperatures likely to be encountered in the human body these changes are unlikely to occur, but provide evidence that polypropylene materials should never undergo sterilization with autoclave heat or γ radiation.…”

Section: Potential Complicationsmentioning

confidence: 99%

The scientific basis for the use of biomaterials in stress urinary incontinence (SUI) and pelvic organ prolapse (POP)

2014

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Objectives To review the scientific and clinical literature to assess the basis for the use of biomaterials in stress urinary incontinence (SUI) and pelvic organ prolapse (POP). Pelvic floor diseases (PFDS), such as SUI and POP, are common and vexing disorders. While synthetic mesh‐based repairs have long been considered an option for PFD treatment, and their efficacy established in randomised clinical trials, safety of its use has recently been called into question. Materials and Methods Using the PubMed, MEDLINE and Medical Subject Headings (MeSH) databases, we performed a critical review of English‐language publications that contained the following keywords: ‘pelvic organ prolapse’, ‘stress urinary incontinence’, ‘mesh’, ‘biomaterial’, ‘collagen’, ‘elastin’ and ‘extracellular matrix’. After reviewing for relevance for mesh use in the pelvis by two independent reviewers with a third available in the case of disagreement, a total of 60 articles were included in the present review. Results We found that many of the potential causes of PFDs are due to altered metabolism of patient extracellular matrix (specifically collagen, elastin, and their respective enzymes) and as such, repairs using native tissue may suffer from the same abnormalities leading to a subsequent lack of repair integrity. However, mesh use is not without its unique risks. Several publications have suggested that biomaterials may undergo alteration after implantation, but these findings have not been demonstrated in the normal milieu. Conclusion While the decision for the use of synthetic mesh is scientifically sound, its benefits and risks must be discussed with the patient in an informed decision‐making process.

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“…Degradation products may adversely affect exposed humans. Frostling et al studied the effects of PP degradation in animals [81], comparing levels of glutathione, an abundant antioxidant found in high concentrations in the liver. The authors found significantly lower concentrations of glutathione in the liver, lung, and brain of exposed rats.…”

Section: Degradation Of Pp Meshmentioning

confidence: 99%

Polypropylene mesh and the host response

2012

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Analytical, occupational and toxicologic aspects of the degradation products of polypropylene plastics.

Cited by 28 publications

References 4 publications

Degradation of polypropylene in vivo: A microscopic analysis of meshes explanted from patients

Degradation of polypropylene in vivo: A microscopic analysis of meshes explanted from patients

The scientific basis for the use of biomaterials in stress urinary incontinence (SUI) and pelvic organ prolapse (POP)

Polypropylene mesh and the host response

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