Resistance to adhesion formation: A comparative study of treated and untreated mesh products placed in the abdominal cavity

González, Ricardo Rodríguez; Rodeheaver, George T.; Moody, D. L.; Foresman, Pamela A.; Ramshaw, Bruce

doi:10.1007/s10029-004-0213-x

Cited by 72 publications

(60 citation statements)

References 10 publications

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“…Com relação à estrutura espacial da tela, observouse em diversos estudos através da microscopia eletrônica, que as telas micro porosas têm estrutura mais laminar, o que permite depósito mais regular e organizado das células mesoteliais, permitindo a formação de um neo-peritônio nos primeiros dias após a sua colocação e, assim, diminuindo a formação de aderências 5,6,9,13 . Na prótese laminar ocorre mesotelização de forma simétrica e regular ao passo que na reticular o depósito do mesotélio é irregular e desorganizado, propiciando formação de aderências nos locais descobertos por mesotélio 6,9,13 .…”

Section: Estrutura Tridimensional Da Próteseunclassified

“…Na prótese laminar ocorre mesotelização de forma simétrica e regular ao passo que na reticular o depósito do mesotélio é irregular e desorganizado, propiciando formação de aderências nos locais descobertos por mesotélio 6,9,13 . Fica claro, então, que a face laminar da tela deve ficar disposta para o interior da cavidade, isto é, em contato com as vísceras.…”

Section: Estrutura Tridimensional Da Próteseunclassified

“…O seu uso, em comparação à simples rafia do defeito aponeurótico, reduziu consideravelmente os índices de recidivas das hérnias 3,7,11,13 . Estes valores variam de casuística para casuística, mas supõe-se que o uso de telas reduz a formação de hérnia incisional de cerca de 30-40% 2,18 para 5-10% 11 .…”

Section: Introductionunclassified

“…Estes valores variam de casuística para casuística, mas supõe-se que o uso de telas reduz a formação de hérnia incisional de cerca de 30-40% 2,18 para 5-10% 11 . Conforme vários autores, dentre as próteses sintéticas atualmente disponíveis em nosso meio, a tela de polipropileno ainda é o material mais utilizado 2,13,16,17,24 . O uso intra-abdominal de telas, contudo, tem indicações restritas, pois a colocação intra-peritoneal destas próteses apresenta complicações, podendo cursar com a formação de aderências, fístulas êntero-cutâneas 9,11,12,13,14,18,23 e até mesmo oclusão intestinal 11,13,18,23 , sendo esta última, a complicação mais séria da formação de aderências 10,21 .…”

Section: Introductionunclassified

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Escolha do material da tela para disposição intra-peritoneal na correção cirúrgica de defeitos herniários da parede abdominal

Araújo

Czeczko

Deallarmi

et al. 2010

ABCD, arq. bras. cir. dig.

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INTRODUÇÃO: O uso de telas para a correção cirúrgica de defeito herniários da parede abdominal contribuiu para a acentuada redução dos índices de recidiva das hérnias. Contudo, o seu uso intra-abdominal cursa com a formação de aderências e diversas complicações, dentre elas a obstrução intestinal. MÉTODO: Foram selecionados, nos bancos de dados PubMed e Medline, 27 artigos científicos atualizados e com informações relevantes à respeito das propriedades mais importantes das telas (material, diâmetro dos poros, estrutura tridimensional e peso molecular) para colocação intra-abdominal, evitando-se a formação de aderências e recidiva da hérnia. CONCLUSÃO: Atualmente as telas de dupla-composição são as mais indicadas para uso intra-peritoneal. Estas têm uma face composta por um material (preferencialmente macro poroso e reticular) que fica em contato com a musculatura e tem o objetivo de manter a resistência tênsil da parede abdominal. A outra face, composta por outro tipo de material (preferencialmente micro poroso e laminar), deve ficar em contato com os órgãos intra-abdominais, porém sem induzir a formação de aderências

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Section: Estrutura Tridimensional Da Próteseunclassified

Section: Introductionunclassified

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Escolha do material da tela para disposição intra-peritoneal na correção cirúrgica de defeitos herniários da parede abdominal

Araújo

Czeczko

Deallarmi

et al. 2010

ABCD, arq. bras. cir. dig.

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“…Schulze et al showed that collagen sealant (a bioabsorbable material containing type-1 collagen) prevented the migration of Parietex composite mesh during an 8-week period when it was used as a fixator [21]. The signs of inflammation in the surrounding tissue, adhesions around the mesh, and strength of adhesion separation were reduced with absorbable coverage of the fixators [21,22].…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Adhesions to Intraperitoneally Placed Fixation Materials: A Laparoscopic Study in Rats

et al. 2010

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After laparoscopic ventral hernia repair, the nature of the adhesions to fixation materials or to mesh had not been clarified. We examined adhesion formation specific to the fixation material in rats. We designed an experimental laparoscopy setup, and placed four intraperitoneal fixation materials on the peritoneum of rats without a mesh graft. Another group of researchers documented the incidence and intensity of postoperative adhesion formation. The adhesion scores for the nickeltitanium anchor were significantly greater than those for polylactic acid (p=0.004), a titanium tacker (p<0.0001), and fibrin glue (p<0.0001). No adhesions occurred in the fibrin glue group. Fibrin glue is the preferred fixation material because it produced no postoperative adhesions. The nickel-titanium anchor produced heavy adhesions but may be applicable for recurrent hernia cases and in patients with thin abdominal walls.

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Peritoneum‐Inspired Janus Porous Hydrogel with Anti‐Deformation, Anti‐Adhesion, and Pro‐Healing Characteristics for Abdominal Wall Defect Treatment

Liang

Huang

et al. 2022

Advanced Materials

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layers has attracted remarkable attention in recent years for surgical challenge and undesirable treatment outcomes. The destruction of the muscular layer is difficult to be sutured and injury of the serosal membrane could induce obvious viscera adhesion. [5,6] In the past few decades, tension-free repair operation is recommended as the standard treatment for soft-tissue defects like abdominal wall defects, in which different types of patches have been widely used. [1,[7][8][9] Traditional synthetic meshes with high strength, light weight, and anti-deformation (e.g., polypropylene (PP) and polyester meshes) have been widely used for tension-free repair of soft-tissue defects. But these meshes could result in severe visceral adhesion and undesirable wound healing, because of an obvious foreign body reaction (Figure 1a). [10][11][12] One of the most common approaches to solve the problem of visceral adhesion is to develop composite patches with anti-adhesion barriers. [9,13] For example, Parietex composite (PCO) mesh has been successfully designed to prevent visceral adhesion by coating an anti-adhesive collagen-based barrier on polyester mesh. [14,15] Nevertheless, these polyester or PP-based composite meshes could cause undesirable wound healing, due to their inherent unsatisfied inflammation response and lack of suitable microstructure for cells to migrate and grow. [16,17] Moreover, the collagen-based barrier would swell and cause deformation of composite meshes in an abdominal wet environment [18] (Figure 1b). Currently, the Implantable meshes used in tension-free repair operations facilitate treatment of internal soft-tissue defects. However, clinical meshes fail to achieve anti-deformation, anti-adhesion, and pro-healing properties simultaneously, leading to undesirable surgery outcomes. Herein, inspired by the peritoneum, a novel biocompatible Janus porous poly(vinyl alcohol) hydrogel (JPVA hydrogel) is developed to achieve efficient repair of internal soft-tissue defects by a facile yet efficient strategy based on top-down solvent exchange. The densely porous and smooth bottom-surface of JPVA hydrogel minimizes adhesion of fibroblasts and does not trigger any visceral adhesion, and its loose extracellular-matrix-like porous and rough top-surface can significantly improve fibroblast adhesion and tissue growth, leading to superior abdominal wall defect treatment to commercially available PP and PCO meshes. With unique anti-swelling property (maximum swelling ratio: 6.4%), JPVA hydrogel has long-lasting anti-deformation performance and maintains high mechanical strength after immersion in phosphate-buffered saline (PBS) for 14 days, enabling tolerance to the maximum abdominal pressure in an internal wet environment. By integrating visceral anti-adhesion and defect pro-healing with anti-deformation, the JPVA hydrogel patch shows great prospects for efficient internal soft-tissue defect repair.

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Resistance to adhesion formation: A comparative study of treated and untreated mesh products placed in the abdominal cavity

Cited by 72 publications

References 10 publications

Escolha do material da tela para disposição intra-peritoneal na correção cirúrgica de defeitos herniários da parede abdominal

Escolha do material da tela para disposição intra-peritoneal na correção cirúrgica de defeitos herniários da parede abdominal

Comparative Evaluation of Adhesions to Intraperitoneally Placed Fixation Materials: A Laparoscopic Study in Rats

Peritoneum‐Inspired Janus Porous Hydrogel with Anti‐Deformation, Anti‐Adhesion, and Pro‐Healing Characteristics for Abdominal Wall Defect Treatment

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