Modified mesh for hernia repair that is adapted to the physiology of the abdominal wall

Klinge, U.; Klosterhalfen, B.; Conze, Joachim; Limberg, W.; Obolenski, Boris; Öttinger, A.; Schumpelick, Volker

doi:10.1080/110241598750005138

Cited by 253 publications

(174 citation statements)

References 2 publications

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“…This may be due to the infiltration of fibroblastic host cells that produce new ECM. After 2 months, both materials displayed increased strength (N/cm) and were within the physiologic limits required for successful abdominal wall hernia treatment [36].…”

Section: Discussionmentioning

confidence: 99%

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One and four layer acellular bladder matrix for fascial tissue reconstruction

Eberli

Atala

Yoo

2011

J Mater Sci: Mater Med

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To determine whether the use of multiple layers of acellular bladder matrix (ABM) is more suitable for the treatment of abdominal wall hernia than a single layered ABM. The feasibility, biocompatibility and mechanical properties of both materials were assessed and compared. Biocompatibility testing was performed on 4 and 1 layered ABM. The matrices were used to repair an abdominal hernia model in 24 rabbits. The animals were followed for up to 3 months. Immediately after euthanasia, the implant site was inspected and samples were retrieved for histology, scanning electron microscopy and biomechanical studies. Both acellular biomaterials demonstrated excellent biocompatibility. At the time of retrieval, there was no evidence of infection. The matrices demonstrated biomechanical properties comparable to native tissue. Three hernias (25%) were found in the single layer ABM group and only 1 hernia (8%) was found in the 4 layer ABM group. Histologically, the matrix structure was intact and the cell density within the matrices decreased with time. The dominant cell type present within the matrices shifted from lymphocytes to fibroblasts over time. Both ABMs maintained adequate strength over time when used for hernia repair, and there was an extremely low incidence of adhesion formation. The single layer ABM showed enhanced cellular integration, while the 4 layer ABM reduced hernia formation. Either of these matrices may be useful as an off-the-shelf biomaterial for patients requiring fascial repair. TITLE:ONE To determine whether the use of multiple layers of acellular bladder matrix (ABM) is more suitable for the treatment of abdominal wall hernia than a single layered ABM. The feasibility, biocompatibility and mechanical properties of both materials were assessed and compared.Design and Method: Biocompatibility testing was performed on 4 and 1 layered ABM.The matrices were used to repair an abdominal hernia model in 24 rabbits. The animals were followed for up to 3 months. Immediately after euthanasia, the implant site was inspected and samples were retrieved for histology, scanning electron microscopy and biomechanical studies.Results: Both acellular biomaterials demonstrated excellent biocompatibility. At the time of retrieval, there was no evidence of infection. The matrices demonstrated biomechanical properties comparable to native tissue. Three hernias (25%) were found in the single layer ABM group and only 1 hernia (8%) was found in the 4 layer ABM group.Histologically, the matrix structure was intact and the cell density within the matrices decreased with time. The dominant cell type present within the matrices shifted from lymphocytes to fibroblasts over time.

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Section: Discussionmentioning

confidence: 99%

“…For potential materials to be used in abdominal hernia repairs, the strength (N/cm) is considered the most important factor [36]. Therefore, all measurements were expressed as strength (Figure 3).…”

Section: Biomechanical Studiesmentioning

confidence: 99%

One and four layer acellular bladder matrix for fascial tissue reconstruction

Eberli

Atala

Yoo

2011

J Mater Sci: Mater Med

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“…Over the next few years heavy weight meshes were replaced by medium to light weight meshes that reduced the bulk of the foreign material leading to less inflammation, foreign body reaction, fibrosis and the associated pain sensation [34]. Also the pore sizes were made larger (macroporous).…”

Section: Evolvement Of the Polypropylene Mesh As A Materialsmentioning

confidence: 99%

“…On the other hand, the modern surgical mesh constructed from a knitted polypropylene has smaller pores with an area density of 90-95 g/m 2 . These heavy-weight, first generation meshes are now known to cause a vigorous foreign body reaction and resulting dense scar tissue leading to a loss of the compliance of the abdominal wall [34].…”

Section: Evolvement Of the Polypropylene Mesh As A Materialsmentioning

confidence: 99%

Synthetic Materials Used in the Surgical Treatment of Pelvic Organ Prolapse: Problems of Currently Used Material and Designing the Ideal Material

Mangır¹,

Chapple²,

MacNeil³

2018

Pelvic Floor Disorders

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Synthetic materials have long been used to provide structural support when surgically repairing pelvic organ prolapse (POP). The most widely used synthetic material is a mesh made of polypropylene (PPL). The use of mesh is intended to improve cure rates and prevent recurrences after POP surgery -however as more mesh materials have been implanted, it has become apparent that serious complications can occur in up to 30% of women, particularly when the mesh is implanted transvaginally. Over the years many different mesh kits have been marketed and used in the treatment of POP however polypropylene mesh was never designed or tested for use in pelvic floor. Instead it was approved for clinical use based on its biocompatibility and success in abdominal hernia repairs. It is now known that PPL meshes are neither compliant with the mechanical forces in the pelvic floor nor do they integrate well into paravaginal tissues. Better materials developed specifically for use in pelvic floor are urgently needed. The aim of this chapter is to define the requirements of an ideal mesh in terms of its material properties and to summarize the ongoing research on developing the next generation pelvic floor repair materials.

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“…Low weight density (LW) prostheses were then developed ( fig.8), characterized by a lower concentration of synthetic material and larger pores (>1,000 µm). The first experimental tests were performed with a hybrid prosthesis of LW PP and polyglactine (Klinge et al, 1998), which was later sold under the name Vypro II ® (Ethicon, Johnson&Johnson, Somerville, USA). Then pure LW PP prostheses were developed and disseminated, such as Parietene ® (Tyco, Healthcare, Mansfield, MA), with a 38g/m 2 density and 1.15 +-0.05 mm 2 pores and Optilene elastic ® (Braun, Spangerwerg, Germany), with 48g/m 2 and 7.64 +-0.32mm 2 pores (Bellón, 2009).…”

Section: Fig 7 Augmentation Picture Of Polypropylene Prosthesismentioning

confidence: 99%

The Use of Biomaterials to Treat Abdominal Hernias

Zogbi¹

2011

Biomaterials Applications for Nanomedicine

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Modified mesh for hernia repair that is adapted to the physiology of the abdominal wall

Cited by 253 publications

References 2 publications

One and four layer acellular bladder matrix for fascial tissue reconstruction

One and four layer acellular bladder matrix for fascial tissue reconstruction

Synthetic Materials Used in the Surgical Treatment of Pelvic Organ Prolapse: Problems of Currently Used Material and Designing the Ideal Material

The Use of Biomaterials to Treat Abdominal Hernias

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