Expanded polytetrafluoroethylene patch for the repair of large abdominal wall defects

Lei, Berend van der; Bleichrodt, Robert P.; Simmermacher, R. K. J.; Schilfgaarde, R. van

doi:10.1002/bjs.1800760813

Cited by 77 publications

(25 citation statements)

References 7 publications

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“…Another observation is the fact that Gore-Tex patches, once penetrated by a needle, present a small aperture which enlarges with the seesawing effect of the suture, thus resulting in "mini-hernias'. This "buttonhole" complication has already been reported by Monaghan (1991) and Van der Lei (1989). Polypropylene on the other hand presented a problem of a different nature, as observed on three patients in the operating room.…”

Section: Discussionmentioning

confidence: 67%

Composite mesh (polypropylene-e-PTFE) in the intraperitoneal position

Bendavid

1997

Hernia

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The treatment of incisionaI hernias, on occasions, imposes the use of an intraperitoneal prosthesis. Though none of the available biomaterials is entirely satisfactory, the choice often reflects a compromise. Polypropylene and polyester have been associated with bowel obstruction, fistulization and transmigration through a viscus. These problems are almost unknown with e-PTFE. All three however can cause adhesions. On the other hand, the solidity of a repair is a function of the penetration of a prosthesis by fibroblasts and collagen. Polyester and polypropylene manifest such a penetration. e-PTFE less so. The combination of e-PTFE internally and polypropylene externally seems to provide a reasonable composite which has been used in 30 cases in the last six years. During that period no patient presented with an intestinal occlusion or fistula.

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Section: Discussionmentioning

confidence: 67%

Composite mesh (polypropylene-e-PTFE) in the intraperitoneal position

Bendavid

1997

Hernia

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“…In our view PTFE, polypropylene and polyester meshes are all appropriate in tension-free hernioplasties. However, we prefer PTFE for the following reasons: it is an inert bio-material [Berliner 1994]; it produces no foreign-body reaction [Van der Lei 1989]; it is highly resistant [Murphy 1989;Law 199o]; and finally, it behaves well in cases of infection [Brown z985]. In addition, these authors report fewer instances of adhesions, and also that the mesh is easier to remove.…”

Section: Discussionmentioning

confidence: 97%

Thovara repair of inguinal hernias

Vara-Thorbeck

Ruiz-Morales

Segovia-Cornejo

1998

Hernia

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Summary: A new procedure for inguinal hernia is described: the Thovara method. This technique is really a modified version of Lichtenstein's tensionfree hernioplasty to which is added a Kirschner-like transposition of the spermatic cord. Between 1988 and 1992, 654 Thovara hernioplasties were performed. 95% (621) patients underwent physical examination one year after the operation and 511 (78%) were reexamined five years after surgery. Early recurrences (< I year) were noted in five cases (0,8%). In three cases the mesh had to be removed because of infection. In late follow-up (5 years) no recurrences were observed but in five cases (1%) testicular atrophy was present. The Thovara method is a simple and physiological repair, which eliminates recurrence, the "b~te noire" of inguinal herniorrhaphies. However, almost one half of recurrences are discovered five to ten years after the operation and final evaluation of this technique must await randomized controlled trials and comparisons with alternatives.

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“…PET is supposed to be degraded after some years, which has been proven at vascular grafts made of PET [78][79][80][81]. PTFE is usually manufactured in the form of foils, thus lacking a sufficient integration into the surrounding tissue [82] and with the consequence of encapsulation instead of ingrowth and subsequent extensive shrinkage. Bellon .…”

Section: Biomaterials Compositionmentioning

confidence: 99%

Mesh biocompatibility: effects of cellular inflammation and tissue remodelling

Junge

Binnebösel

Trotha

et al. 2011

Langenbecks Arch Surg

121

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Mesh biocompatibility is basically determined by the foreign body reaction (FBR). In contrast to physiological wound healing and scar formation, the FBR at the host-tissue/biomaterial interface is present for the lifetime of the medical device. The cellular interactions at the mesh/tissue interface proceed over time ending up in a chronic inflammatory process. The time course of the FBR has been studied extensively and consists of three crucial steps that are protein absorption, cell recruitment and, finally, fibrotic encapsulation and extracellular matrix formation. Each of these steps involves a complex cascade of immune modulators including soluble mediators and various cell types. Recent research has focused on the cellular and molecular interactions of the distinct phases of the FBR offering a new basis for therapeutical strategies. The highly dynamic process of the FBR is considerably influenced by the biomaterial composition. Modifications of the type of polymer, the material weight, the filament structure and the pore size are realized and have substantial effects on the in vivo biocompatibility. Moreover, modern mesh technology aims to utilize the available implants as carrier systems for bioactive drugs. Studies in animal models account for the efficiency of these drugs that aim to reduce mesh-related infections or to minimize FBR by influencing inflammation or extracellular matrix remodelling. A thorough understanding of the molecular mechanisms of FBR provides a sophisticated background for the development of new biomaterials at least as carrier systems for bioactive reagents to reduce inflammation and to improve clinical outcome.

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Expanded polytetrafluoroethylene patch for the repair of large abdominal wall defects

Cited by 77 publications

References 7 publications

Composite mesh (polypropylene-e-PTFE) in the intraperitoneal position

Composite mesh (polypropylene-e-PTFE) in the intraperitoneal position

Thovara repair of inguinal hernias

Mesh biocompatibility: effects of cellular inflammation and tissue remodelling

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