1
|
Keric N, Campbell A. Meshing around: high-risk hernias and infected mesh. Trauma Surg Acute Care Open 2024; 9:e001379. [PMID: 38646030 PMCID: PMC11029232 DOI: 10.1136/tsaco-2024-001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Open laparotomy carries a risk up to 20% for an incisional hernia, making repair one of the most common operations performed by general surgeons in the USA. Despite a multitude of mesh appliances and techniques, no size fits all, and there is continued debate on what is the best mesh type, especially in high-risk patients with contaminated hernias. Infected mesh carries a significant burden to the patient, the surgeon and overall healthcare costs with medical legal implications. A stepwise approach that involves optimization of patient comorbidities, patient selective choice of mesh and technique is imperative in mitigating outcomes and recurrence rates. This review will focus on the avoidance of mesh infection and the selection of mesh in patients with contaminated wounds.
Collapse
Affiliation(s)
- Natasha Keric
- Surgery, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA
- Surgery, Banner—University Medical Center Phoenix, Phoenix, Arizona, USA
| | | |
Collapse
|
2
|
Capella-Monsonís H, Zeugolis DI. Decellularized xenografts in regenerative medicine: From processing to clinical application. Xenotransplantation 2021; 28:e12683. [PMID: 33709410 DOI: 10.1111/xen.12683] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/28/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
Decellularized xenografts are an inherent component of regenerative medicine. Their preserved structure, mechanical integrity and biofunctional composition have well established them in reparative medicine for a diverse range of clinical indications. Nonetheless, their performance is highly influenced by their source (ie species, age, tissue) and processing (ie decellularization, crosslinking, sterilization and preservation), which govern their final characteristics and determine their success or failure for a specific clinical target. In this review, we provide an overview of the different sources and processing methods used in decellularized xenografts fabrication and discuss their effect on the clinical performance of commercially available decellularized xenografts.
Collapse
Affiliation(s)
- Héctor Capella-Monsonís
- 1Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
| | - Dimitrios I Zeugolis
- 1Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| |
Collapse
|
3
|
A critical review of the in vitro and in vivo models for the evaluation of anti-infective meshes. Hernia 2018; 22:961-974. [PMID: 30168006 DOI: 10.1007/s10029-018-1807-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/18/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Infectious complications following mesh implantation for abdominal wall repair appear in 0.7 up to 26.6% of hernia repairs and can have a detrimental impact for the patient. To prevent or to treat mesh-related infection, the scientific community is currently developing a veritable arsenal of antibacterial meshes. The numerous and increasing reports published every year describing new technologies indicate a clear clinical need, and an academic interest in solving this problem. Nevertheless, to really appreciate, to challenge, to compare and to optimize the antibacterial properties of next generation meshes, it is important to know which models are available and to understand them. PURPOSE We proposed for the first time, a complete overview focusing only on the in vitro and in vivo models which have been employed specifically in the field of antibacterial meshes for hernia repair. RESULTS AND CONCLUSION From this investigation, it is clear that there has been vast progress and breadth in new technologies and models to test them. However, it also shows that standardization or adoption of a more restricted number of models would improve comparability and be a benefit to the field of study.
Collapse
|
4
|
Guillaume O, Pérez-Tanoira R, Fortelny R, Redl H, Moriarty TF, Richards RG, Eglin D, Petter Puchner A. Infections associated with mesh repairs of abdominal wall hernias: Are antimicrobial biomaterials the longed-for solution? Biomaterials 2018; 167:15-31. [PMID: 29554478 DOI: 10.1016/j.biomaterials.2018.03.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 03/09/2018] [Accepted: 03/12/2018] [Indexed: 12/30/2022]
Abstract
The incidence of mesh-related infection after abdominal wall hernia repair is low, generally between 1 and 4%; however, worldwide, this corresponds to tens of thousands of difficult cases to treat annually. Adopting best practices in prevention is one of the keys to reduce the incidence of mesh-related infection. Once the infection is established, however, only a limited number of options are available that provides an efficient and successful treatment outcome. Over the past few years, there has been a tremendous amount of research dedicated to the functionalization of prosthetic meshes with antimicrobial properties, with some receiving regulatory approval and are currently available for clinical use. In this context, it is important to review the clinical importance of mesh infection, its risk factors, prophylaxis and pathogenicity. In addition, we give an overview of the main functionalization approaches that have been applied on meshes to confer anti-bacterial protection, the respective benefits and limitations, and finally some relevant future directions.
Collapse
Affiliation(s)
- O Guillaume
- AO Research Institute Davos, Clavadelerstrasse 8, CH 7270, Davos, Switzerland.
| | - R Pérez-Tanoira
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
| | - R Fortelny
- Department of General, Visceral and Oncologic Surgery, Wilhelminen Hospital, Montleartstrasse 37, 1160, Vienna, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstraße 13, A-1200, Vienna, Austria; Sigmund Freud University, Medical Faculty, Kelsenstraße 2, A-1030, Vienna, Austria
| | - H Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstraße 13, A-1200, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Donaueschingenstrasse 13, A-1200, Vienna, Austria
| | - T F Moriarty
- AO Research Institute Davos, Clavadelerstrasse 8, CH 7270, Davos, Switzerland
| | - R G Richards
- AO Research Institute Davos, Clavadelerstrasse 8, CH 7270, Davos, Switzerland
| | - D Eglin
- AO Research Institute Davos, Clavadelerstrasse 8, CH 7270, Davos, Switzerland
| | - A Petter Puchner
- Department of General, Visceral and Oncologic Surgery, Wilhelminen Hospital, Montleartstrasse 37, 1160, Vienna, Austria; Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstraße 13, A-1200, Vienna, Austria
| |
Collapse
|
5
|
Xu Z, Chang J, Zhang P, Guan X, Chen Y, Fan H. Collagen modified with epoxidized safrole for improving antibacterial activity. RSC Adv 2017. [DOI: 10.1039/c7ra08319j] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
An epoxidized safrole, 5-(oxiran-2-ylmethyl)-benzo[d][1,3]dioxole (OYBD), was synthesized and employed to modify collagen for improving its antibacterial activity.
Collapse
Affiliation(s)
- Zhou Xu
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education
- Sichuan University
- Chengdu 610065
- China
- School of Life Science and Food Engineering
| | - Jinming Chang
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education
- Sichuan University
- Chengdu 610065
- China
| | - Peikun Zhang
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education
- Sichuan University
- Chengdu 610065
- China
| | - Xiaoyu Guan
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education
- Sichuan University
- Chengdu 610065
- China
| | - Yi Chen
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education
- Sichuan University
- Chengdu 610065
- China
| | - Haojun Fan
- Key Laboratory of Leather Chemistry and Engineering of Ministry of Education
- Sichuan University
- Chengdu 610065
- China
| |
Collapse
|
6
|
Langbach O, Kristoffersen AK, Abesha-Belay E, Enersen M, Røkke O, Olsen I. Oral, intestinal, and skin bacteria in ventral hernia mesh implants. J Oral Microbiol 2016; 8:31854. [PMID: 27476443 PMCID: PMC4967714 DOI: 10.3402/jom.v8.31854] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/29/2016] [Accepted: 06/21/2016] [Indexed: 11/14/2022] Open
Abstract
Background In ventral hernia surgery, mesh implants are used to reduce recurrence. Infection after mesh implantation can be a problem and rates around 6–10% have been reported. Bacterial colonization of mesh implants in patients without clinical signs of infection has not been thoroughly investigated. Molecular techniques have proven effective in demonstrating bacterial diversity in various environments and are able to identify bacteria on a gene-specific level. Objective The purpose of this study was to detect bacterial biofilm in mesh implants, analyze its bacterial diversity, and look for possible resemblance with bacterial biofilm from the periodontal pocket. Methods Thirty patients referred to our hospital for recurrence after former ventral hernia mesh repair, were examined for periodontitis in advance of new surgical hernia repair. Oral examination included periapical radiographs, periodontal probing, and subgingival plaque collection. A piece of mesh (1×1 cm) from the abdominal wall was harvested during the new surgical hernia repair and analyzed for bacteria by PCR and 16S rRNA gene sequencing. From patients with positive PCR mesh samples, subgingival plaque samples were analyzed with the same techniques. Results A great variety of taxa were detected in 20 (66.7%) mesh samples, including typical oral commensals and periodontopathogens, enterics, and skin bacteria. Mesh and periodontal bacteria were further analyzed for similarity in 16S rRNA gene sequences. In 17 sequences, the level of resemblance between mesh and subgingival bacterial colonization was 98–100% suggesting, but not proving, a transfer of oral bacteria to the mesh. Conclusion The results show great bacterial diversity on mesh implants from the anterior abdominal wall including oral commensals and periodontopathogens. Mesh can be reached by bacteria in several ways including hematogenous spread from an oral site. However, other sites such as gut and skin may also serve as sources for the mesh biofilm.
Collapse
Affiliation(s)
- Odd Langbach
- Department of Gastroenterologic Surgery, Akershus University Hospital, University of Oslo, Lørenskog, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway;
| | | | - Emnet Abesha-Belay
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Morten Enersen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ola Røkke
- Department of Gastroenterologic Surgery, Akershus University Hospital, University of Oslo, Lørenskog, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingar Olsen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| |
Collapse
|
7
|
Pérez-Köhler B, Bayon Y, Bellón JM. Mesh Infection and Hernia Repair: A Review. Surg Infect (Larchmt) 2015; 17:124-37. [PMID: 26654576 DOI: 10.1089/sur.2015.078] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The use of a prosthetic mesh to repair a tissue defect may produce a series of post-operative complications, among which infection is the most feared and one of the most devastating. When occurring, bacterial adherence and biofilm formation on the mesh surface affect the implant's tissue integration and host tissue regeneration, making preventive measures to control prosthetic infection a major goal of prosthetic mesh improvement. METHODS This article reviews the literature on the infection of prosthetic meshes used in hernia repair to describe the in vitro and in vivo models used to examine bacterial adherence and biofilm formation on the surface of different biomaterials. Also discussed are the prophylactic measures used to control implant infection ranging from meshes soaked in antibiotics to mesh coatings that release antimicrobial agents in a controlled manner. RESULTS Prosthetic architecture has a direct effect on bacterial adherence and biofilm formation. Absorbable synthetic materials are more prone to bacterial colonization than non-absorbable materials. The reported behavior of collagen biomeshes, also called xenografts, in a contaminated environment has been contradictory, and their use in this setting needs further clinical investigation. New prophylactic mesh designs include surface modifications with an anti-adhesive substance or pre-treatment with antibacterial agents or metal coatings. CONCLUSIONS The use of polymer coatings that slowly release non-antibiotic drugs seems to be a good strategy to prevent implant contamination and reduce the onset of resistant bacterial strains. Even though the prophylactic designs described in this review are mainly focused on hernia repair meshes, these strategies can be extrapolated to other implantable devices, regardless of their design, shape or dimension.
Collapse
Affiliation(s)
- Bárbara Pérez-Köhler
- 1 Department of Surgery, Medical and Social Sciences. Faculty of Medicine and Health Sciences. University of Alcalá . Madrid, Spain .,2 Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Yves Bayon
- 3 Covidien - Sofradim Production , Trévoux, France
| | - Juan Manuel Bellón
- 1 Department of Surgery, Medical and Social Sciences. Faculty of Medicine and Health Sciences. University of Alcalá . Madrid, Spain .,2 Networking Research Center on Bioengineering , Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| |
Collapse
|
8
|
Pérez-Köhler B, García-Moreno F, Brune T, Pascual G, Bellón JM. Preclinical Bioassay of a Polypropylene Mesh for Hernia Repair Pretreated with Antibacterial Solutions of Chlorhexidine and Allicin: An In Vivo Study. PLoS One 2015; 10:e0142768. [PMID: 26556805 PMCID: PMC4640885 DOI: 10.1371/journal.pone.0142768] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 10/27/2015] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Prosthetic mesh infection constitutes one of the major complications following hernia repair. Antimicrobial, non-antibiotic biomaterials have the potential to reduce bacterial adhesion to the mesh surface and adjacent tissues while avoiding the development of novel antibiotic resistance. This study assesses the efficacy of presoaking reticular polypropylene meshes in chlorhexidine or a chlorhexidine and allicin combination (a natural antibacterial agent) for preventing bacterial infection in a short-time hernia-repair rabbit model. METHODS Partial hernia defects (5 x 2 cm) were created on the lateral right side of the abdominal wall of New Zealand White rabbits (n = 21). The defects were inoculated with 0.5 mL of a 106 CFU/mL Staphylococcus aureus ATCC25923 strain and repaired with a DualMesh Plus antimicrobial mesh or a Surgipro mesh presoaked in either chlorhexidine (0.05%) or allicin-chlorhexidine (900 μg/mL-0.05%). Fourteen days post-implant, mesh contraction was measured and tissue specimens were harvested to evaluate bacterial adhesion to the implant surface (via sonication, S. aureus immunolabeling), host-tissue incorporation (via staining, scanning electron microscopy) and macrophage response (via RAM-11 immunolabeling). RESULTS The polypropylene mesh showed improved tissue integration relative to the DualMesh Plus. Both the DualMesh Plus and the chlorhexidine-soaked polypropylene meshes exhibited high bacterial clearance, with the latter material showing lower bacterial yields. The implants from the allicin-chlorhexidine group displayed a neoformed tissue containing differently sized abscesses and living bacteria, as well as a diminished macrophage response. The allicin-chlorhexidine coated implants exhibited the highest contraction. CONCLUSIONS The presoaking of reticular polypropylene materials with a low concentration of chlorhexidine provides the mesh with antibacterial activity without disrupting tissue integration. Due to the similarities found with the antimicrobial DualMesh Plus material, the chlorhexidine concentration tested could be utilized as a prophylactic treatment to resist infection by prosthetic mesh during hernia repair.
Collapse
Affiliation(s)
- Bárbara Pérez-Köhler
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá. Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Francisca García-Moreno
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá. Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | | | - Gemma Pascual
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá. Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Juan Manuel Bellón
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá. Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
- * E-mail:
| |
Collapse
|
9
|
Melnik I, Goldstein D, Yoffe B. Use of a porcine dermal collagen implant for contaminated abdominal wall reconstruction in a 105-year-old woman: a case report and review of the literature. J Med Case Rep 2015; 9:95. [PMID: 25925149 PMCID: PMC4437687 DOI: 10.1186/s13256-015-0569-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 03/06/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Repair of contaminated abdominal wall defect in a geriatric patient is a challenge for the surgeon. We present the case of the oldest patient (105-years old) to successfully undergo a single-stage repair of a contaminated abdominal wall defect with a Permacol™ implant. CASE PRESENTATION A 105-year-old Caucasian woman presented to our emergency room with a clinical and radiological diagnosis of small bowel obstruction due to prior operative adhesions. She underwent laparotomy with small bowel resection and primary closure of her abdomen. There was total eventration of her bowel through the suture line 9 days after surgery. She underwent a second laparotomy that revealed no signs of peritonitis or turbid fluid. Her abdomen was closed with a 15 × 10 cm Permacol™ implant sutured sublay with prolene sutures. Her postoperative period was unremarkable. After a follow-up period of 3 years and 2 months, there was no sign of recurrent hernia or wound contamination. CONCLUSION We suggest that Permacol™ mesh can be considered an efficient alternative to primary closure or synthetic mesh in geriatric patients with contaminated abdominal wall defects.
Collapse
Affiliation(s)
- Idit Melnik
- Department of General and Vascular Surgery, Barzilai Medical Center, Hahistadrout St 2, Ashkelon, 78278, Israel.
| | - Dimitry Goldstein
- Department of General and Vascular Surgery, Barzilai Medical Center, Hahistadrout St 2, Ashkelon, 78278, Israel.
| | - Boris Yoffe
- Department of General and Vascular Surgery, Barzilai Medical Center, Hahistadrout St 2, Ashkelon, 78278, Israel.
| |
Collapse
|
10
|
Pérez-Köhler B, Sotomayor S, Rodríguez M, Gegúndez MI, Pascual G, Bellón JM. Bacterial adhesion to biological versus polymer prosthetic materials used in abdominal wall defect repair: do these meshes show any differences in vitro? Hernia 2015; 19:965-73. [PMID: 25862028 DOI: 10.1007/s10029-015-1378-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 04/03/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Although clinical data suggest the similar performance of collagen-based biological prosthetic materials to some polymer materials, the use of a biomesh for abdominal hernia repair in a setting of infection is controversial. This in vitro study compares the adhesion of two Staphylococcus strains to polymer and biological meshes. METHODS Sterile fragments of Optilene(®) (Op), Surgipro™ (Surg), Preclude(®) (Precl), TIGR(®) (TIGR), Bio-A(®) (BioA), Permacol™ (Perm), Surgisis(®) (SIS), and Tutomesh(®) (Tuto) were inoculated with 10(6) CFU of S. aureus (Sa) or S. epidermidis (Se) (n = 18 per strain per mesh). The first five meshes are polymer materials while Perm, SIS and Tuto are biomeshes. After 24/48 h of incubation, bacterial adhesion was examined by sonication, scanning electron microscopy (SEM) and light microscopy. RESULTS Sa and Se showed a high affinity for the absorbable meshes (TIGR, BioA, Perm, SIS, Tuto) (p < 0.001). Precl yielded the lowest bacterial loads (p < 0.001). Surg, Precl and BioA underwent no substantial change over time, while Op (p < 0.001) and TIGR (p < 0.05) showed decreasing bacterial loads during incubation. The Sa-contaminated biomeshes behaved similarly while biomeshes inoculated with Se returned higher bacterial yields at 48 h, especially SIS (p < 0.001). SEM and light microscopy observations revealed planktonic bacteria and biofilms on the polymer surface and bacterial niches in biomesh pores. CONCLUSIONS Within 48 h of contamination, the absorbable polymer and biological meshes exhibited high bacterial loads. Given their lower affinity for both bacterial strains, the conventional non-absorbable polymer materials could be better candidates for use in contaminated surgical fields.
Collapse
Affiliation(s)
- B Pérez-Köhler
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Ctra. Madrid-Barcelona, Km 33,600, Alcalá De Henares, 28871, Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - S Sotomayor
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.,Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - M Rodríguez
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Ctra. Madrid-Barcelona, Km 33,600, Alcalá De Henares, 28871, Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - M I Gegúndez
- Department of Biomedicine and Biotechnology, Faculty of Pharmacy, University of Alcalá, Madrid, Spain
| | - G Pascual
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.,Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain
| | - J M Bellón
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Ctra. Madrid-Barcelona, Km 33,600, Alcalá De Henares, 28871, Madrid, Spain. .,Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
| |
Collapse
|
11
|
Augustine R, Dominic EA, Reju I, Kaimal B, Kalarikkal N, Thomas S. Electrospun poly(ε-caprolactone)-based skin substitutes:In vivoevaluation of wound healing and the mechanism of cell proliferation. J Biomed Mater Res B Appl Biomater 2014; 103:1445-54. [DOI: 10.1002/jbm.b.33325] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 08/23/2014] [Accepted: 11/04/2014] [Indexed: 12/27/2022]
Affiliation(s)
- Robin Augustine
- International and Inter University Centre for Nanoscience and Nanotechnology, Mahatma Gandhi University; Kottayam 686 560 Kerala India
| | - Edwin Anto Dominic
- Pushpagiri Research Centre, Pushpagiri Institute of Medical Sciences & Research Centre; Tiruvalla 689 101 Kerala India
| | - Indu Reju
- Pushpagiri Research Centre, Pushpagiri Institute of Medical Sciences & Research Centre; Tiruvalla 689 101 Kerala India
| | - Balarama Kaimal
- Pushpagiri Research Centre, Pushpagiri Institute of Medical Sciences & Research Centre; Tiruvalla 689 101 Kerala India
| | - Nandakumar Kalarikkal
- International and Inter University Centre for Nanoscience and Nanotechnology, Mahatma Gandhi University; Kottayam 686 560 Kerala India
- School of Pure and Applied Physics, Mahatma Gandhi University; Kottayam 686 560 Kerala India
| | - Sabu Thomas
- International and Inter University Centre for Nanoscience and Nanotechnology, Mahatma Gandhi University; Kottayam 686 560 Kerala India
- School of Chemical Sciences, Mahatma Gandhi University; Kottayam 686 560 Kerala India
| |
Collapse
|
12
|
An experimental comparison of the effects of bacterial colonization on biologic and synthetic meshes. Hernia 2014; 19:197-205. [DOI: 10.1007/s10029-014-1290-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 07/15/2014] [Indexed: 11/26/2022]
|
13
|
Evaluation of a porcine dermal collagen (permacol) implant for abdominal wall reconstruction in a pediatric multitrauma patient. Case Rep Emerg Med 2014; 2014:585723. [PMID: 24839568 PMCID: PMC4006564 DOI: 10.1155/2014/585723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 02/04/2014] [Indexed: 11/17/2022] Open
Abstract
The presence of a contaminated surgical field in abdominal wall defects caused by trauma presents a challenge for surgeons. Both primary suture and synthetic meshes are strongly discouraged as surgical treatments in such cases. We describe the use of a porcine dermal collagen (Permacol) implant in an eight-year-old patient with multiple injuries. Three months after discharge, the child remains well with good cosmetic results. He is free of pain and has returned to full activity levels with complete wound closure and without any evidence of residual hernia. In conclusion, our experience indicates that the use of Permacol can be considered an efficient technique for reconstructing an infected abdominal wall defect of a pediatric multitrauma patient.
Collapse
|