Comparison of Long-Term Biocompability of PVDF and PP Meshes

Klink, Christian D.; Junge, K.; Binnebösel, Marcel; Alizai, H. P.; Otto, Jens; Neumann, Ulf; Klinge, U.

doi:10.3109/08941939.2011.589883

Cited by 66 publications

(52 citation statements)

References 36 publications

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“…An increased amount of premature collagen type III is present in the early phase of wound healing which is later on being replaced by highly cross-linked and stable collagen type I [27]. A high collagen I/III ratio shows the maturing of the scar tissue, therefore demonstrating an adequate wound healing [15]. The high collagen I/III ratio and its significant increase in PVDF sutures therefore indicate a fast tissue remodeling activity of this material.…”

Section: Discussionmentioning

confidence: 99%

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Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

et al. 2015

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Background: Biocompatibility and tissue integration of a surgical suture are decisive factors for wound healing and therefore for the success of sutures. The optimal suture material is still under discussion. Polyvinylidene fluoride (PVDF) is described to have superior properties of biocompatibility and is therefore frequently used as a mesh component. Only little information is available about its use as a suture material. The aim of this study was to evaluate the biocompatibility of PVDF as a suture material in comparison to 5 different established sutures in a rat model. Methods: In 30 male rats, a monofilamental PVDF suture (Resopren®) and 5 established control suture materials [polyester (Miralene®), polytetrafluoroethylene (Gore®), poliglecaprone (Monocryl®), polydioxanone (Monoplus®), polyglactin 910 (Vicryl®), USP size 3-0] were placed in the subcutaneous layer of the abdominal wall without knot or tension. After 3, 7 or 21 days, the abdominal walls were explanted for histopathological and immunohistochemical investigation with special regard to the size and quality of foreign body granuloma and the length of the comet tail-like infiltrate (CTI). Results: The PVDF sutures showed the smallest size of foreign body granuloma (60 ± 14 µm) and the smallest CTI length (343 ± 60 µm) of all polymers after 21 days. Only PVDF (Resopren) and polydioxanone (Monoplus) showed a significant collagen I/III ratio increase between days 3 and 21 (p = 0.009 and p = 0.016). The quality of foreign body reaction regarding inflammation, proliferation and fibrotic remodeling was similar between all suture materials. Conclusions: Our data indicate that monofilamental PVDF sutures show a favorable foreign body reaction with small granuloma sizes and CTI length in comparison to established sutures. Its use as a suture material in general surgery could therefore be extended in the future. To reinforce these findings, further clinical studies need to be conducted.

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Section: Discussionmentioning

confidence: 99%

“…Until now, PVDF has shown superior properties in multiple studies [15,16,17] and has become one of the most promising mesh materials. Nevertheless, in the literature, there is only little information about PVDF as a suture material in general surgery [18,19].…”

Section: Discussionmentioning

confidence: 99%

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

et al. 2015

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“…The mesh is made of monofilament polyvinyl fluoride, claiming a higherbiocompatibility and biostability than polypropylene. 7 According to the description of the manufacturer DynaMesh-PR4 V R mesh is the same mesh as DynaMesh-PR V R ; therefore, for strain measurements of the small center part, a DynaMesh-PR V R mesh (10 cm 3 15 cm) was taken. Because of the identical structure and form of the both arms, only one arm was tested.…”

Section: Methodsmentioning

confidence: 99%

Elongation of textile pelvic floor implants under load is related to complete loss of effective porosity, thereby favoring incorporation in scar plates

Otto

Kaldenhoff

Kirschner‐Hermanns

et al. 2013

J Biomedical Materials Res

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Use of textile structures for reinforcement of pelvic floor structures has to consider mechanical forces to the implant, which are quite different to the tension free conditions of the abdominal wall. Thus, biomechanical analysis of textile devices has to include the impact of strain on stretchability and effective porosity. Prolift V R and Prolift 1 M V R , developed for tension free conditions, were tested by measuring stretchability and effective porosity applying mechanical strain. For comparison, we used Dynamesh-PR4 V R , which was designed for pelvic floor repair to withstand mechanical strain. Prolift V R at rest showed moderate porosity with little stretchability but complete loss of effective porosity at strain of 4.9 N/cm. Prolift 1 M V R revealed an increased porosity at rest, but at strain showed high stretchability, with subsequent loss of effective porosity at strain of 2.5 N/cm. Dynamesh PR4 V R preserved its high porosity even under strain, but as consequence of limited stretchability. Though in tension free conditions Prolift V R and Prolift 1 M V R can be considered as large pore class I meshes, application of mechanical strain rapidly lead to collapse of pores. The loss of porosity at mechanical stress can be prevented by constructions with high structural stability. Assessment of porosity under strain was found helpful to define requirements for pelvic floor devices. Clinical studies have to prove whether devices with high porosity as well as high structural stability can improve the patients' outcome.

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“…The implants could be made of polypropylene (PP), polyethylene terephthalate (PET), expanded polytetrafluoroethylene (ePTFE), polyvinylidene fluoride (PVDF), and absorbable materials, such as polylactide (PLA), polyglycolic acid (PGA), polycaprolactone (PCL) and polydioxanone (PDO) [16]. In studies PVDF showed highly effective porosity [17], stability [18], less foreign body reaction [19] and superior ageing resistance [20]. Prof. Dr. W. Jager used polyvinylidene fluoride tape and the first results demonstrated, that urge and mixed urinary incontinence could be treated not only prescribing medication, but also by the surgery.…”

Section: Discussionmentioning

confidence: 99%

Urge Urinary Incontinence And Pelvic Organ Prolapse Treatment By Cervicosacropexy (CESA): First Steps In Lithuania

et al. 2016

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Key words: cervicosacropexy (CESA), vaginosacropexy (VASA), urinary incontinence, overactive bladder syndrome, mixed urinary incontinence, polyvinylidene fluoride tape, uterosacral ligaments. SummaryBackground. The purpose of our study is to evaluate and present the results of the first cervicosacropexy (CESA) in Lithuania, which was performed in Klaipeda university hospital. Materials and methods. For the 62 years old female patient suffering from overactive bladder syndrome, confirmed by urodynamic test, and II⁰ pelvic organ prolapse (by pelvic organ prolapse quantification classification) cervicosacropexy using polyvinylidene fluoride (PVDF) tape was performed in Klaipeda University Hospital in 2016. Urinary incontinence was evaluated by voiding diary, International Consultation on Incontinence Modular Questionnaire -Short Form (ICIQ-SF) and Overactive Bladder Symptom Score (OABSS), that were filled by the patient before the surgery and 2, 4, 8 weeks after it. Urinary urgency, episodes of urinary incontinence, the need of sanitary pads and urinary frequency were compared before and after the surgery. To assess urinary incontinence impact on daily life, the General King's Health Questionnaire (GKHQ) was used before and after the procedure. Results. After the surgery decrease of episodes of urinary incontinence, urinary frequency during day and night, urinary urgency and the need of sanitary pads were observed. Moreover, the patient could hold the urine longer after feeling the need to urinate. IntroductionUrge urinary incontinence (UUI) is a bothersome urogenital disorder that affects approximately one third of postmenopausal women. Urgency, frequency and incontinence -this triad has detrimental effects on the patient's quality of life and proves to be a source of anxiety [1]. According to Herzog, Fultz and Thom, about 40 % of all women will develop urinary incontinence during their life, usually starting around the age of 50 [3,4]. This is a debilitating disorder, which massively restricts the social and private life of the patient [5]. Known pharmacological treatment attempts to reduce the urinary incontinence symptoms; however, there is no cure addressing the basic cause of the disease [6]. Moreover, pharmacological treatment is slightly more effective than placebo [7]. Treatment of UUI is now focused on antimuscarinic drug therapy, botulinum intravesical injection, sacral neuromodulation, and behavioral interventions [7]. Despite many known treatment methods of UUI, surgery is not widely practiced.Little is known about causes of UUI. Recent physiological and clinical researches are focused on descriptions and development of etiological theories. The most promising theories indicate abnormalities in control of bladder function resulting from aberrations of neurological signals from the bladder (sensation) as well as signals from continence controlling central and peripheral nervous system [7].In 1991 de Lancey emphasized the importance of the support of the genital tract for continence function [8]. He con...

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Comparison of Long-Term Biocompability of PVDF and PP Meshes

Abstract: Our current data suggest that even in the long-term course after six months and despite a higher effective surface of the PVDF samples it showed a smaller foreign body granuloma than with PP whereas the cellular response was similar.

Cited by 66 publications

References 36 publications

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

Polyvinylidene Fluoride as a Suture Material: Evaluation of Comet Tail-Like Infiltrate and Foreign Body Granuloma

Elongation of textile pelvic floor implants under load is related to complete loss of effective porosity, thereby favoring incorporation in scar plates

Urge Urinary Incontinence And Pelvic Organ Prolapse Treatment By Cervicosacropexy (CESA): First Steps In Lithuania

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