Highly purified collagen coating enhances tissue adherence and integration properties of monofilament polypropylene meshes

Siniscalchi, Rodrigo Teixeira; Melo, Marli; Palma, Paulo César Rodrigues; Fabbro, Inácio Maria Dal; Vidal, Benedicto de Campos; Riccetto, Cássio

doi:10.1007/s00192-013-2109-8

Cited by 14 publications

(12 citation statements)

References 26 publications

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“…Patients with recurrent urinary incontinence have worse outcomes and a higher likelihood of failure in any subsequent anti-incontinence technique, mostly in the long term, and fibrotic tissue around urethra can limit its mobility and prevent sling to achieve ideal support to the urethra [16][17][18][19][20][21]. Although SIMS is a very heterogeneous group, worse long-term results among patients with previous surgeries support the hypothesis that longstanding success could depend on the grade and pattern of interaction between the sling and suburethral support tissues [22].…”

Section: Discussionmentioning

confidence: 99%

Mini-Sling Ophira at 8 Years Follow-Up: Does It Sustain Results?

et al. 2019

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Purpose: To evaluate mini-sling long-term results and correlate them to failure predictors. Many studies show comparable results among different single-incision slings developed as an attempt to reduce complications while keeping good results, but there is a lack of evidence about mini-slings outcomes in the long term. Methods: This prospective, single-center study evaluated 40 patients for long-term outcomes after mini-sling placement. Objective cure was defined as leakage of less than 1 g in 1-hour pad-test and no leakage at Valsalva maneuver. An objective improvement was defined as leakage of a maximum 50% of the preoperative test. Subjective continence was considered as a zero score at International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Patients were also evaluated for comorbidities and previous surgeries. Results: The mean age was 56 (±9.3) years, the mean ICIQ-SF score was 16 (±2.98) before surgery and 3.5 (± 5) at last follow-up, showing sustained improvement in the long term, mean 100 (84–109) months follow-up. The objective results show 67.5% of success, 17.5% of improvement, and 15% of failure. Age and parity were not related to outcomes (p = 0.33), but previous surgeries increase failure rate with 5.66 OR (p = 0.04). Success, improvement, and failure rates were 85, 10, and 5% for treatment-naive patients versus 50, 25, and 25% for patients with previous surgeries, respectively. Conclusion: Mini-sling Ophira shows good long-term results with low complications rates in patients without previous anti-incontinence surgery. Randomized trials are necessary to compare mini-slings results to other mid-urethral slings in recurred stress urinary incontinence.

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Section: Discussionmentioning

confidence: 99%

Mini-Sling Ophira at 8 Years Follow-Up: Does It Sustain Results?

et al. 2019

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“…Other techniques like coating with highly purified collagen or fetal collagen both in a rat model [44,45] and platelet-enriched plasma in a rabbit model [46] have shown promising biocompatibility improvements in vivo. Even a study using a macaques model for the investigation of extracellular matrix regenerative graft reported that regenerative extracellular matrix graft attenuated the negative impact of polypropylene on the vagina [47].…”

Section: Discussionmentioning

confidence: 99%

Protocol for a Randomized Phase II Trial for Mesh Optimization by Autologous Plasma Coating in Prolapse Repair: IDEAL Stage 3

et al. 2017

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Introduction: Mesh-related complications especially after vaginal implantation have raised awareness lately because of severe adverse reactions and legal aspects. About 20% of patients suffer from complications after mesh insertion in the anterior vaginal wall. Autologous plasma coating of meshes prior to implantation has shown potential to improve the biocompatibility of meshes in vivo and in vitro. This inno-

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“…In addition to this study, several others, albeit using different methods, have described histological and molecular changes after the implantation of biomaterials, in particular, polypropylene ( 8 , 9 , 10 , 11 ). An inflammatory response to macroporous monofilament PP was demonstrated in explanted meshes from humans one year after implantation and it was observed that this material had little long-term influence on the extracellular matrix composition, represented by the fraction of collagen and elastin in the tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the biological response is not only a consequence of the contact between host and polymer, but is also a result of chemical changes in the preparation process ( 7 ). Several mechanical and histological characteristics secondary to PP implants in living organisms have been demonstrated ( 8 - 10 ). Most of the histological and immunohistochemical evaluations are based on the description of cellular types and/or semi-quantitative measurements of their distribution in randomized samples ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Host inflammatory response to polypropylene implants: insights from a quantitative immunohistochemical and birefringence analysis in a rat subcutaneous model

et al. 2016

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Objectives To describe acute and sub acute aspects of histological and immunohistochemical response to PP implant in a rat subcutaneous model based on objective methods.Materials and Methods Thirty rats had a PP mesh subcutaneously implanted and the same dissection on the other side of abdomen but without mesh (sham). The animals were euthanized after 4 and 30 days. Six slides were prepared using the tissue removed: one stained with hematoxylin-eosin (inflammation assessment); one unstained (birefringence evaluation) and four slides for immunohistochemical processing: IL-1 and TNF-α (pro-inflammatory cytokines), MMP-2 (collagen metabolism) and CD-31 (angiogenesis). The area of inflammation, the birefringence index, the area of immunoreactivity and the number of vessels were objectively measured.Results A larger area of inflammatory reaction was observed in PP compared to sham on the 4th and on the 30th day (p=0.0002). After 4 days, PP presented higher TNF (p=0.0001) immunoreactivity than sham and no differences were observed in MMP-2 (p=0.06) and IL-1 (p=0.08). After 30 days, a reduction of IL-1 (p=0.010) and TNF (p=0.016) for PP and of IL-1 (p=0.010) for sham were observed. Moreover, area of MMP-2 immunoreactivity decreased over time for PP group (p=0.018). Birefringence index and vessel counting showed no differences between PP and sham (p=0.27 and p=0.58, respectively).Conclusions The implantation of monofilament and macroporous polypropylene in the subcutaneous of rats resulted in increased inflammatory activity and higher TNF production in the early post implant phase. After 30 days, PP has similar cytokines immunoreactivity, vessel density and extracellular matrix organization.

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Highly purified collagen coating enhances tissue adherence and integration properties of monofilament polypropylene meshes

Abstract: Polypropylene mesh coated with purified collagen gel increases adherence to tissue, promotes a less intense and lasting inflammatory response and triggers a greater organization and packing arrangement of collagen fibers in the late phase of implantation.

Cited by 14 publications

References 26 publications

Mini-Sling Ophira at 8 Years Follow-Up: Does It Sustain Results?

Mini-Sling Ophira at 8 Years Follow-Up: Does It Sustain Results?

Protocol for a Randomized Phase II Trial for Mesh Optimization by Autologous Plasma Coating in Prolapse Repair: IDEAL Stage 3

Host inflammatory response to polypropylene implants: insights from a quantitative immunohistochemical and birefringence analysis in a rat subcutaneous model

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