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Xie Y, Liu W, Yang Y, Shi M, Li J, Sun Y, Wang Y, Zhang J, Zheng Y. Fabrication of a modified bacterial cellulose with different alkyl chains and its prevention of abdominal adhesion. Int J Biol Macromol 2024; 273:133191. [PMID: 38880455 DOI: 10.1016/j.ijbiomac.2024.133191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
Abdominal hernia mesh is a common product which is used for prevention of abdominal adhesion and repairing abdominal wall defect. Currently, designing and preparing a novel bio-mesh material with prevention of adhesion, promoting repair and good biocompatibility simultaneously remain a great bottleneck. In this study, a novel siloxane-modified bacterial cellulose (BC) was designed and fabricated by chemical vapor deposition silylation, then the effects of different alkyl chains length of siloxane on surface properties and cell behaviors were explored. The effect of preventing of abdominal adhesion and repairing abdominal wall defect in rats with the siloxane-modified BC was evaluated. As the grafted alkyl chains become longer, the surface of the siloxane-modified BC can be transformed from super hydrophilic to hydrophobic. In vivo results showed that BC-C16 had good long-term anti-adhesion effect, good tissue adaptability and histocompatibility, which is expected to be used as a new anti-adhesion hernia repair material in clinic.
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Affiliation(s)
- Yajie Xie
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Wenbo Liu
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Yingying Yang
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Miaojie Shi
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Junfei Li
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Yi Sun
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Yansen Wang
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Jian Zhang
- Shanghai Changzheng Hospital, 415 Fengyang Street, Shanghai 200003, China.
| | - Yudong Zheng
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing 100083, China.
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Shiroud Heidari B, Dodda JM, El-Khordagui LK, Focarete ML, Maroti P, Toth L, Pacilio S, El-Habashy SE, Boateng J, Catanzano O, Sahai N, Mou L, Zheng M. Emerging materials and technologies for advancing bioresorbable surgical meshes. Acta Biomater 2024:S1742-7061(24)00327-1. [PMID: 38879102 DOI: 10.1016/j.actbio.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/22/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
Surgical meshes play a significant role in the treatment of various medical conditions, such as hernias, pelvic floor issues, guided bone regeneration, and wound healing. To date, commercial surgical meshes are typically made of non-absorbable synthetic polymers, notably polypropylene and polytetrafluoroethylene, which are associated with postoperative complications, such as infections. Biological meshes, based on native tissues, have been employed to overcome such complications, though mechanical strength has been a main disadvantage. The right balance in mechanical and biological performances has been achieved by the advent of bioresorbable meshes. Despite improvements, recurrence of clinical complications associated with surgical meshes raises significant concerns regarding the technical adequacy of current materials and designs, pointing to a crucial need for further development. To this end, current research focuses on the design of meshes capable of biomimicking native tissue and facilitating the healing process without post-operative complications. Researchers are actively investigating advanced bioresorbable materials, both synthetic polymers and natural biopolymers, while also exploring the performance of therapeutic agents, surface modification methods and advanced manufacturing technologies such as 4D printing. This review seeks to evaluate emerging biomaterials and technologies for enhancing the performance and clinical applicability of the next-generation surgical meshes. STATEMENT OF SIGNIFICANCE: In the ever-transforming landscape of regenerative medicine, the embracing of engineered bioabsorbable surgical meshes stands as a key milestone in addressing persistent challenges and complications associated with existing treatments. The urgency to move beyond conventional non-absorbable meshes, fraught with post-surgery complications, emphasises the necessity of using advanced biomaterials for engineered tissue regeneration. This review critically examines the growing field of absorbable surgical meshes, considering their potential to transform clinical practice. By strategically combining mechanical strength with bioresorbable characteristics, these innovative meshes hold the promise of mitigating complications and improving patient outcomes across diverse medical applications. As we navigate the complexities of modern medicine, this exploration of engineered absorbable meshes emerges as a promising approach, offering an overall perspective on biomaterials, technologies, and strategies adopted to redefine the future of surgical meshes.
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Affiliation(s)
- Behzad Shiroud Heidari
- Centre for Orthopaedic Research, Medical School, The University of Western Australia, Nedlands, WA, Australia
| | - Jagan Mohan Dodda
- New Technologies - Research Centre (NTC), University of West Bohemia, Univerzitní 8, 301 00 Pilsen, Czech Republic.
| | | | - Maria Letizia Focarete
- Department of Chemistry "Giacomo Ciamician" and INSTM UdR of Bologna, University of Bologna, Italy. Health Sciences & Technologies (HST) CIRI, University of Bologna, Via Tolara di Sopra 41/E, 40064 Ozzano Emilia, Italy
| | - Peter Maroti
- University of Pecs, Medical School, 3D Printing and Visualization Centre, Hungary, University of Pecs, Medical Skills Education and Innovation Centre, Hungary
| | - Luca Toth
- University of Pecs, Medical School, Institute for Translational Medicine, Hungary, University of Pecs, Medical School, Department of Neurosurgery, Hungary
| | - Serafina Pacilio
- Department of Chemistry "Giacomo Ciamician" and INSTM UdR of Bologna, University of Bologna, Italy. Health Sciences & Technologies (HST) CIRI, University of Bologna, Via Tolara di Sopra 41/E, 40064 Ozzano Emilia, Italy; Department of Biomedical and Neuromotor Sciences DIBINEM, Alma Mater Studiorum-University of Bologna, Italy
| | - Salma E El-Habashy
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Egypt
| | - Joshua Boateng
- Faculty of Engineering and Science, University of Greenwich, Medway Campus, UK
| | - Ovidio Catanzano
- Institute for Polymers, Composites and Biomaterials (IPCB-CNR), Via Campi Flegrei 34, 80078 Pozzuoli, NA, Italy
| | - Nitin Sahai
- University of Pecs, Medical School, 3D Printing and Visualization Centre, Hungary, University of Pecs, Medical Skills Education and Innovation Centre, Hungary; Department of Biomedical Engineering, North Eastern Hill University, Meghalaya, India
| | - Lingjun Mou
- WA Liver and Kidney Transplant Department, Sir Charles Gairdner Hospital, Western Australia, Australia
| | - Minghao Zheng
- Centre for Orthopaedic Research, Medical School, The University of Western Australia, Nedlands, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
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Polyák P, Vadász KF, Tátraaljai D, Puskas JE. Preparation of surgical meshes using self-regulating technology based on reaction-diffusion processes. Med Biol Eng Comput 2024:10.1007/s11517-024-03141-9. [PMID: 38837082 DOI: 10.1007/s11517-024-03141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
While reaction-diffusion processes are utilized in multiple scientific fields, these phenomena have seen limited practical application in the polymer industry. Although self-regulating processes driven by parallel reaction and diffusion can lead to patterned structures, most polymeric products with repeating subunits are still prepared by methods that require complex and expensive instrumentation. A notable, high-added-value example is surgical mesh, which is often manufactured by weaving or knitting. In our present work, we demonstrate how the polymer and the biomedical industry can benefit from the pattern-forming capabilities of reaction-diffusion. We would like to propose a self-regulating method that facilitates the creation of surgical meshes from biocompatible polymers. Since the control of the process assumes a thorough understanding of the underlying phenomena, the theoretical background, as well as a mathematical model that can accurately describe the empirical data, is also introduced and explained. Our method offers the benefits of conventional techniques while introducing additional advantages not attainable with them. Most importantly, the method proposed in this paper enables the rapid creation of meshes with an average pore size that can be adjusted easily and tailored to fit the intended area of application.
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Affiliation(s)
- Péter Polyák
- Laboratory of Plastics and Rubber Technology, Department of Physical Chemistry and Materials Science, Budapest University of Technology and Economics, Műegyetem rkp. 3., Budapest, 1111, Hungary.
- Department of Food, Agricultural and Biological Engineering, The Ohio State University, 1680 Madison Avenue, Wooster, 44691, OH, USA.
| | - Katalin Fodorné Vadász
- Laboratory of Plastics and Rubber Technology, Department of Physical Chemistry and Materials Science, Budapest University of Technology and Economics, Műegyetem rkp. 3., Budapest, 1111, Hungary
- Institute of Materials and Environmental Chemistry, Research Centre for Natural Sciences, Magyar Tudósok Körútja 2., Budapest, H-1117, Hungary
| | - Dóra Tátraaljai
- Laboratory of Plastics and Rubber Technology, Department of Physical Chemistry and Materials Science, Budapest University of Technology and Economics, Műegyetem rkp. 3., Budapest, 1111, Hungary
- Institute of Materials and Environmental Chemistry, Research Centre for Natural Sciences, Magyar Tudósok Körútja 2., Budapest, H-1117, Hungary
| | - Judit E Puskas
- Department of Food, Agricultural and Biological Engineering, The Ohio State University, 1680 Madison Avenue, Wooster, 44691, OH, USA
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Nosheen S, Mukhtar H, Haider S, Khan R, Sharif F. Tissue engineered multifunctional chitosan-modified polypropylene hernia mesh loaded with bioactive phyto-extracts. Int J Biol Macromol 2024; 271:132282. [PMID: 38750855 DOI: 10.1016/j.ijbiomac.2024.132282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/07/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024]
Abstract
Surface modified tissue engineered polypropylene / PP hernia meshes were fabricated by incorporating Bacterial cellulose / BC and chitosan / CS and phytochemical extracts. Under current practice, hernia and other traumatic injuries to the abdominal organs are clinically treated with surgical meshes. Often the foreign body reaction and infections result in relapse in patients which dictates additional reparative surgical procedures and pain. To improve the outcome of clinical restorative procedures new biomaterials with improved characteristics are required. The functionalized meshes were physically and chemically characterized using SEM, mechanical testing, FTIR and XRD. The antimicrobial activity was qualitatively and quantitatively tested using E. coli and S. aureus strains of bacteria. In vitro biocompatibility and wound healing effect of the modified meshes were performed using NIH3T3 fibroblast cell lines. Furthermore, tissue engineering potential of the meshes was evaluated using confocal fluorescent microscopy. In vivo implantation of the meshes was performed in male wistar rats for 21 days. Therefore, PP meshes with sustained drug delivery system augmented with anti-inflammatory and anti-microbial characteristics were developed. The coatings hereby not only increased the tensile strength of meshes but also prevented the modified meshes from causing infection. Current study resulted in CS-BC bioactive PP meshes loaded with phytochemicals which showed anti-inflammatory, antibacterial and wound healing potential. These meshes can be valuable to lessen the post-surgical complications of implanted PP mesh and thus reduce rejection and recurrence.
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Affiliation(s)
- Sadaf Nosheen
- Interdisciplinary Research Centre in Biomedical Materials, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan, 54000; Dr. Ikram-Ul-Haq Institute of Industrial Biotechnology (IIB), GC University, Katchery Road, Lahore, Pakistan, 54000
| | - Hamid Mukhtar
- Dr. Ikram-Ul-Haq Institute of Industrial Biotechnology (IIB), GC University, Katchery Road, Lahore, Pakistan, 54000
| | - Sajjad Haider
- Chemical Engineering Department, College of Engineering, King Saud University, P.O.Box 800, Riyadh 11421, Saudi Arabia
| | - Rawaiz Khan
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Faiza Sharif
- Interdisciplinary Research Centre in Biomedical Materials, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan, 54000; Department of Materials Science & Engineering, Kroto Research Institute, University of Sheffield, Broad Lane, Sheffield, UK.
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Baker JJ, Rosenberg J. Coatings for Permanent Meshes Used to Enhance Healing in Abdominal Hernia Repair: A Scoping Review. Surg Innov 2024:15533506241255258. [PMID: 38803124 DOI: 10.1177/15533506241255258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Hernia meshes are used to reduce recurrence and pain rates, but the rates are still high. This could be improved with coatings of the mesh. This scoping review aimed to provide an overview of mesh coatings used to promote healing in abdominal hernia repair and to report beneficial and unbeneficial effects. METHODS We included human and animal studies with abdominal hernias that were repaired with non-commercially coated meshes. We searched Pubmed, Embase, Cochrane Central, LILACS, and CNKI without language constraints. RESULTS Of 2933 identified studies, 58 were included: six studies had a total of 408 humans and 52 studies had 2679 animals. The median follow-up was 12 months (range 1-156), and 95% of the hernias were incisional. There were 44 different coatings which included platelet-rich plasma, mesenchymal stem cells, growth factors, vitamin E, collagen-derived products, various polysaccharides, silk proteins, chitosan, gentamycin, doxycycline, nitrofurantoin, titanium, and diamond-like carbon. Mesenchymal stem cells and platelet-rich plasma were the most researched. Mesenchymal stem cells notably reduced inflammation and foreign body reactions but did not impact other healing metrics. In contrast, platelet-rich plasma positively influenced tissue ingrowth, collagen deposition, and neovascularization and had varying effects on inflammation and foreign body reactions. CONCLUSION We identified 44 different mesh coatings and they showed varying results. Mesenchymal stem cells and platelet-rich plasma were the most studied, with the latter showing considerable promise in improving biomechanical properties in hernia repair. Further investigations are needed to ascertain their definitive use in humans.
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Affiliation(s)
- Jason Joe Baker
- Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Jacob Rosenberg
- Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
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Giordano C, Rosellini E, Cascone MG, Di Puccio F. In vivo comparison of mesh fixation solutions in open and laparoscopic procedures for inguinal hernia repair: A meta-analysis. Heliyon 2024; 10:e28711. [PMID: 38689996 PMCID: PMC11059548 DOI: 10.1016/j.heliyon.2024.e28711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/22/2024] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
Background Abdominal hernia repair surgeries involve the fixation of a surgical mesh to the abdominal wall with different means such as suture, tacks, and glues. Currently, the most effective mesh fixation system is still debated. This review compares outcomes of mesh fixation in different surgical procedures, aiding surgeons in identifying the optimal technique. Methods A meta-analysis was conducted according to PRISMA guidelines. Articles published between January 2003 and January 2023 were searched in electronic databases. Randomized controlled trials (RCTs) comparing mesh fixation with cyanoacrylate-based or fibrin glues with classical fixation techniques (sutures, tacks) in open and laparoscopic procedures were included. Results 17 RCTs were identified; the cumulative study population included 3919 patients and a total of 3976 inguinal hernias. Cyanoacrylate-based and fibrin glues were used in 1639 different defects, suture and tacks in 1912 defects, self-gripping mesh in 404 cases, and no mesh fixation in 21 defects. Glue fixation resulted in lower early postoperative pain, and chronic pain occurred less frequently. The incidence of hematoma was lower with glue fixation than with mechanical fixation. Recurrence rate, seroma formation, operative and hospitalization time showed no significant differences; but significantly, a higher number of people in the glue group returned to work by 15- and 30-days after surgery when compared to the tacker and suture groups in the same time frame. Conclusion Cyanoacrylate and fibrin glue may be effective in reducing early and chronic pain and hematoma incidence without increasing the recurrence rate, the seroma formation, or the operative and hospitalization time.
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Affiliation(s)
- Cristiana Giordano
- Department of Civil and Industrial Engineering, University of Pisa, Largo Lucio Lazzarino, 56122, Pisa, Italy
| | - Elisabetta Rosellini
- Department of Civil and Industrial Engineering, University of Pisa, Largo Lucio Lazzarino, 56122, Pisa, Italy
| | - Maria Grazia Cascone
- Department of Civil and Industrial Engineering, University of Pisa, Largo Lucio Lazzarino, 56122, Pisa, Italy
| | - Francesca Di Puccio
- Department of Civil and Industrial Engineering, University of Pisa, Largo Lucio Lazzarino, 56122, Pisa, Italy
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Lemdani MS, Niu EF, Amro C, Gala Z, Ewing JN, Honig SE, Broach RB, Fischer JP. Outcomes and Quality of Life After Resorbable Synthetic Ventral Hernia Repair in Contaminated Fields. Ann Plast Surg 2024; 92:S156-S160. [PMID: 38556666 DOI: 10.1097/sap.0000000000003860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION The ideal mesh type for hernia repair in a contaminated field remains controversial. Data regarding outcomes beyond 1 year and the impact on quality of life (QoL) are unknown. This study aims to evaluate the long-term surgical outcomes and patient-reported outcomes (PROs) after contaminated repair with poly-4-hydroxybutyrate (P4HB) mesh. MATERIALS METHODS Patients undergoing a contaminated hernia repair with P4HB between 2015 and 2020 were identified. Surgical site occurrences and hernia recurrences were recorded. Long-term PROs as defined by the Abdominal Hernia-Q and Hernia-Related Quality-of-Life Survey were assessed. RESULTS Fifty-five patients were included with a mean age of 54.5 years, a body mass index of 34 kg/m2, and a defect size of 356.9 ± 227.7 cm2. Median follow-up time was 49 months with a reoperation rate of 14.5% and a hernia recurrence rate of 7.3%. Of the 55 patients, 37 completed preoperative and postoperative PRO questionnaires. When comparing preoperative with postoperative Abdominal Hernia-Q, there was significant improvement in overall PROs (2.1 vs 3.5, P < 0.001). This improvement was maintained with no significant changes between postoperative scores over the course of 5 years. Patients with complications saw the same improvement in postoperative PRO scores as those without complications. CONCLUSIONS Our study found a low hernia recurrence and acceptable long-term reoperation rates in patients undergoing hernia repair with P4HB mesh in a contaminated setting. We demonstrate a sustained significant improvement in QoL scores after hernia repair. These data yield insight into the long-term outcomes and QoL improvement, providing physicians further knowledge to better counsel their patients.
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Affiliation(s)
- Mehdi S Lemdani
- From the Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA
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Kirov KG, Mihaylov DM, Arnaudov SS. Is the self-adhesive mesh a solution for chronic postoperative inguinal pain after TAPP: A single centre preliminary experience? J Minim Access Surg 2024; 20:216-221. [PMID: 37706406 PMCID: PMC11095797 DOI: 10.4103/jmas.jmas_23_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/13/2023] [Accepted: 04/06/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Minimally invasive surgery for groin hernia has expanded significantly over the last two decades and has demonstrated better outcomes in terms of pain and quality of life. A major contributing factor related to chronic post-operative inguinal pain (CPIP) is mesh fixation. An alternative to the standard fixation methods is the self-adhesive surgical mesh. PATIENTS AND METHODS Prospective data analysis was performed of all patients undergoing laparoscopic transabdominal pre-peritoneal (TAPP) inguinal hernia repair in a single centre for the period 1 st January, 2022-15 th December, 2022. A standardised surgical technique was used with a lightweight self-adhesive mesh without additional fixation. The analysis has encompassed early and late post-operative complications as well as the assessment of pain with an emphasis on CPIP. RESULTS The study enrolled 52 patients where a total number of 64 elective hernia repairs were performed: 92.2% ( n = 59) primary and 7.8% ( n = 5) recurrent. Fifty-one patients received post-operative follow-up: 100% at 1 month and 78.8% ( n = 41) at 3 months. The incidence of early postoperative complications was 7.7% ( n = 4): one patient developed a seroma, two patients - port site hematomas and one a transient subileus that were all managed conservatively. No patients suffered a recurrence. The average pain score according to the Visual Analogue Scale was 3.3 (0-8) at discharge, 0.6 (0-4) at 1 month and there was no incidence of CPIP after the 3 rd month. CONCLUSION Laparoscopic TAPP repair for inguinal hernia with a self-adhesive mesh is an adequate surgical technique with the potential to reduce CPIP, but more research is needed to evaluate this method.
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Affiliation(s)
- Kiril G. Kirov
- Research Institute – Medical University Pleven, Pleven, Bulgaria
- Department of Surgery, Oncology Centre Shumen, Shumen, Bulgaria
| | | | - Stefan Svilenov Arnaudov
- Research Institute – Medical University Pleven, Pleven, Bulgaria
- Department of Surgery, Oncology Centre Shumen, Shumen, Bulgaria
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Williams S, Menon A, Shauly O, Van Natta B, Gould D, Losken A. Reviewing Outcomes and Complications with the Use of Mesh in Breast Reduction Surgery. Aesthetic Plast Surg 2024:10.1007/s00266-024-03896-4. [PMID: 38448602 DOI: 10.1007/s00266-024-03896-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/30/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Reduction mammoplasty is a common reconstructive and esthetic procedure with variable long-term outcomes regarding breast shape, projection, and nipple-areolar complex. One common complaint is recurrent breast ptosis, which may be mitigated by sufficient support of the inferior pole. This review will look at the effects of mesh in mitigating postoperative ptosis following reduction mammoplasty. METHODS A comprehensive review of the literature was performed using the PubMed database. Manuscripts that provided data with respect to the effects of mesh on cosmetic outcomes, patient-reported outcomes, complications, and surveillance were utilized. RESULTS Six studies with a total of 634 patients were included in this review. There is limited evidence to support a cosmetic benefit with the use of mesh in reduction mammoplasty patients. While subjective satisfaction was demonstrated in one paper, few others had objective measurements of the impact of mesh. Complications included infection, skin necrosis, and loss of nipple sensation. Mammography was found to not be affected by mesh placement. DISCUSSION The use of mesh during reduction mammoplasty is a relatively modern innovation that does not appear to have a significantly different risk profile than that of traditional reduction procedures. There is limited cosmetic value based on currently available data. More objective future analysis is necessary in order to justify the use of mesh in reduction mammoplasty for its claimed cosmetic benefits. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
| | | | - Orr Shauly
- Emory Division of Plastic and Reconstructive Surgery, 3200 Downwood Circle Northwest, Atlanta, GA, 30327, USA.
| | | | | | - Albert Losken
- Emory Division of Plastic and Reconstructive Surgery, 3200 Downwood Circle Northwest, Atlanta, GA, 30327, USA
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Kaveti R, Lee JH, Youn JK, Jang TM, Han WB, Yang SM, Shin JW, Ko GJ, Kim DJ, Han S, Kang H, Bandodkar AJ, Kim HY, Hwang SW. Soft, Long-Lived, Bioresorbable Electronic Surgical Mesh with Wireless Pressure Monitor and On-Demand Drug Delivery. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2307391. [PMID: 37770105 DOI: 10.1002/adma.202307391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/02/2023] [Indexed: 10/03/2023]
Abstract
Current research in the area of surgical mesh implants is somewhat limited to traditional designs and synthesis of various mesh materials, whereas meshes with multiple functions may be an effective approach to address long-standing challenges including postoperative complications. Herein, a bioresorbable electronic surgical mesh is presented that offers high mechanical strength over extended timeframes, wireless post-operative pressure monitoring, and on-demand drug delivery for the restoration of tissue structure and function. The study of materials and mesh layouts provides a wide range of tunability of mechanical and biochemical properties. Dissolvable dielectric composite with porous structure in a pyramidal shape enhances sensitivity of a wireless capacitive pressure sensor, and resistive microheaters integrated with inductive coils provide thermo-responsive drug delivery system for an antibacterial agent. In vivo evaluations demonstrate reliable, long-lived operation, and effective treatment for abdominal hernia defects, by clear evidence of suppressed complications such as adhesion formation and infections.
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Affiliation(s)
- Rajaram Kaveti
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Joong Hoon Lee
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- SK Hynix Co., Ltd., 2091, Gyeongchung-daero, Bubal-eup, Incheon, Gyeonggi-do, 17336, Republic of Korea
| | - Joong Kee Youn
- Department of Pediatric Surgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Tae-Min Jang
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Won Bae Han
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Seung Min Yang
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- Hanwha Systems Co., Ltd., 188, Pangyoyeok-Ro, Bundang-Gu, Seongnam-si, Gyeonggi-do, 13524, Republic of Korea
| | - Jeong-Woong Shin
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Gwan-Jin Ko
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Dong-Je Kim
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Sungkeun Han
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Heeseok Kang
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Amay J Bandodkar
- Department of Electrical and Computer Engineering, North Carolina State University, Raleigh, NC, 27606, USA
- Center for Advanced Self-Powered Systems of Integrated Sensors and Technologies (ASSIST), North Carolina State University, Raleigh, NC, 27606, USA
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Suk-Won Hwang
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- Department of Integrative Energy Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea
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Spurzem GJ, Broderick RC, Li JZ, Sandler BJ, Horgan S, Jacobsen GR. Maximizing mesh mileage: evaluating the long-term performance of a novel hybrid mesh for ventral hernia repair. Hernia 2024:10.1007/s10029-024-02995-0. [PMID: 38429399 DOI: 10.1007/s10029-024-02995-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/18/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE The objective of this study is to evaluate the safety and long-term outcomes of GORE Synecor™ in ventral hernia repair (VHR). METHODS This retrospective, single-center case review analyzed outcomes in patients who underwent VHR with Synecor from May 2016 to December 2022. Primary outcomes were hernia recurrence and mesh infection rates. Secondary outcomes were 30-day morbidity, 30-day mortality, 30-day readmission, re-operation, surgical-site infection (SSI) and occurrence (SSO) rates, and occurrences requiring intervention (SSOI). RESULTS 278 patients were identified. Mean follow-up was 24.1 (0.2-87.1) months. Mean hernia defect size was 63.4 (± 77.2) cm2. Overall hernia recurrence and mesh infection rates were 5.0% and 1.4% respectively. No mesh infections required full explantation. We report the following overall rates: 13.3% 30-day morbidity, 4.7% 30-day readmission, 2.9% re-operation, 7.2% SSI, 6.1% SSO, and 2.9% SSOI. 30-day morbidity was significantly higher in non-clean (42.1% vs 11.2%, p < 0.01), onlay (OL) mesh (37.0% vs preperitoneal (PP) 16.4%, p = 0.05 vs retrorectus (RR) 15.0%, p < 0.05 vs intraperitoneal (IP) 5.2%, p < 0.001), and open cases (23.5% vs 3.1% laparoscopic vs 4.4% robotic, p < 0.01). SSI rates were significantly higher in non-clean (31.6% vs 5.4%, p < 0.001), OL mesh (29.6% vs RR 11.3%, p < 0.05 vs PP 5.5%, p < 0.01 vs IP 0.0%, p < 0.001), and open cases (15.2% vs 0% laparoscopic vs 0% robotic, p < 0.05). CONCLUSION Long-term performance of a novel hybrid mesh in VHR demonstrates a low recurrence rate and favorable safety profile in various defect sizes and mesh placement locations.
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Affiliation(s)
- G J Spurzem
- Department of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr, La Jolla, CA, 92037, USA.
| | - R C Broderick
- Department of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr, La Jolla, CA, 92037, USA
| | - J Z Li
- Department of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr, La Jolla, CA, 92037, USA
| | - B J Sandler
- Department of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr, La Jolla, CA, 92037, USA
| | - S Horgan
- Department of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr, La Jolla, CA, 92037, USA
| | - G R Jacobsen
- Department of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr, La Jolla, CA, 92037, USA
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12
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Flechas Becerra C, Barrios Silva LV, Ahmed E, Bear JC, Feng Z, Chau DY, Parker SG, Halligan S, Lythgoe MF, Stuckey DJ, Patrick PS. X-Ray Visible Protein Scaffolds by Bulk Iodination. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306246. [PMID: 38145968 PMCID: PMC10933627 DOI: 10.1002/advs.202306246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/18/2023] [Indexed: 12/27/2023]
Abstract
Protein-based biomaterial use is expanding within medicine, together with the demand to visualize their placement and behavior in vivo. However, current medical imaging techniques struggle to differentiate between protein-based implants and surrounding tissue. Here a fast, simple, and translational solution for tracking transplanted protein-based scaffolds is presented using X-ray CT-facilitating long-term, non-invasive, and high-resolution imaging. X-ray visible scaffolds are engineered by selectively iodinating tyrosine residues under mild conditions using readily available reagents. To illustrate translatability, a clinically approved hernia repair mesh (based on decellularized porcine dermis) is labeled, preserving morphological and mechanical properties. In a mouse model of mesh implantation, implants retain marked X-ray contrast up to 3 months, together with an unchanged degradation rate and inflammatory response. The technique's compatibility is demonstrated with a range of therapeutically relevant protein formats including bovine, porcine, and jellyfish collagen, as well as silk sutures, enabling a wide range of surgical and regenerative medicine uses. This solution tackles the challenge of visualizing implanted protein-based biomaterials, which conventional imaging methods fail to differentiate from endogenous tissue. This will address previously unanswered questions regarding the accuracy of implantation, degradation rate, migration, and structural integrity, thereby accelerating optimization and safe translation of therapeutic biomaterials.
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Affiliation(s)
- Carlos Flechas Becerra
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonPaul O'Gorman Building, 72 Huntley StreetLondonWC1E 6DDUK
| | - Lady V. Barrios Silva
- Division of Biomaterials and Tissue EngineeringEastman Dental InstituteUniversity College LondonRoyal Free HospitalRowland Hill StreetLondonNW3 2PFUK
| | - Ebtehal Ahmed
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonPaul O'Gorman Building, 72 Huntley StreetLondonWC1E 6DDUK
| | - Joseph C. Bear
- School of Life SciencePharmacy & ChemistryKingston UniversityPenrhyn RoadKingston upon ThamesKT1 2EEUK
| | - Zhiping Feng
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonPaul O'Gorman Building, 72 Huntley StreetLondonWC1E 6DDUK
| | - David Y.S. Chau
- Division of Biomaterials and Tissue EngineeringEastman Dental InstituteUniversity College LondonRoyal Free HospitalRowland Hill StreetLondonNW3 2PFUK
| | - Samuel G. Parker
- Centre for Medical Imaging, Division of MedicineUniversity College London UCLCharles Bell House, 43–45 Foley StreetLondonW1W 7TSUK
| | - Steve Halligan
- Centre for Medical Imaging, Division of MedicineUniversity College London UCLCharles Bell House, 43–45 Foley StreetLondonW1W 7TSUK
| | - Mark F. Lythgoe
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonPaul O'Gorman Building, 72 Huntley StreetLondonWC1E 6DDUK
| | - Daniel J. Stuckey
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonPaul O'Gorman Building, 72 Huntley StreetLondonWC1E 6DDUK
| | - P. Stephen Patrick
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College LondonPaul O'Gorman Building, 72 Huntley StreetLondonWC1E 6DDUK
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13
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Wang X, Liu C, Li X, Shen T, Lian J, Shi J, Jiang Z, Qiu G, Wang Y, Meng E, Wei G. A novel electrospun polylactic acid silkworm fibroin mesh for abdominal wall hernia repair. Mater Today Bio 2024; 24:100915. [PMID: 38188648 PMCID: PMC10767193 DOI: 10.1016/j.mtbio.2023.100915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
Objective Abdominal wall hernias are common abdominal diseases, and effective hernia repair is challenging. In clinical practice, synthetic meshes are widely applied for repairing abdominal wall hernias. However, postoperative complications, such as inflammation and adhesion, are prevalent. Although biological meshes can solve this problem to a certain extent, they face the problems of heterogeneity, rapid degradation rate, ordinary mechanical properties, and high-cost. Here, a novel electrospinning mesh composed of polylactic acid and silk fibroin (PLA-SF) for repairing abdominal wall hernias was manufactured with good physical properties, biocompatibility and low production cost. Materials and methods FTIR and EDS were used to demonstrate that the PLA-SF mesh was successfully synthesized. The physicochemical properties of PLA-SF were detected by swelling experiments and in vitro degradation experiments. The water contact angle reflected the hydrophilicity, and the stress‒strain curve reflected the mechanical properties. A rat abdominal wall hernia model was established to observe degradation, adhesion, and inflammation in vivo. In vitro cell mesh culture experiments were used to detect cytocompatibility and search for affected biochemical pathways. Results The PLA-SF mesh was successfully synthesized and did not swell or degrade over time in vitro. It had a high hydrophilicity and strength. The PLA-SF mesh significantly reduced abdominal inflammation and inhibited adhesion formation in rat models. The in vitro degradation rate of the PLA-SF mesh was slower than that of tissue remodeling. Coculture experiments suggested that the PLA-SF mesh reduced the expression of inflammatory factors secreted by fibroblasts and promoted fibroblast proliferation through the TGF-β1/Smad pathway. Conclusion The PLA-SF mesh had excellent physicochemical properties and biocompatibility, promoted hernia repair of the rat abdominal wall, and reduced postoperative inflammation and adhesion. It is a promising mesh and has potential for clinical application.
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Affiliation(s)
- Xingjie Wang
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Changjun Liu
- School of Life and Health Sciences, Hunan University of Science and Technology, Xiangtan, 411201, Hunan, China
| | - Xuqi Li
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Tianli Shen
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Jie Lian
- Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Jing Shi
- Department of Respiratory and Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Zhengdong Jiang
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Guanglin Qiu
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Yuanbo Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Er Meng
- School of Life and Health Sciences, Hunan University of Science and Technology, Xiangtan, 411201, Hunan, China
| | - Guangbing Wei
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
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14
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Naraynsingh V, Cawich SO, Hassranah S. Alternative to mesh repair for ventral hernias: Modified rectus muscle repair. World J Surg Proced 2023; 13:14-21. [DOI: 10.5412/wjsp.v13.i3.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/18/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Mesh utilization for ventral hernia repair is associated with potential complications such as mesh infections, adhesions, seromas, fistula formation and significant postoperative pain. The modified rectus muscle repair (RMR) is as an option to repair midline ventral hernias without mesh.
AIM To evaluate the short term outcomes when the modified RMR was used to repair ventral hernias.
METHODS This was a 5-year prospective study that examined the outcome of all consecutive patients with ventral abdominal wall hernias > 5 cm in maximal diameter who underwent repair using the modified RMR technique in a single surgeon unit. Patients were reviewed in an outpatient clinic at 3, 6 and 12 mo and evaluated for hernia recurrence on clinical examination. Each patient’s abdominal wall was also assessed with using ultrasonography at 24 mo to detect recurrences. All data were examined with SPSS ver 18.0.
RESULTS Over the 5-year study period, there were 52 patients treated for ventral hernias at this institution. Four patients were excluded and there were 48 in the final study sample, at a mean age of 56 years (range 28-80). The mean maximal diameter of the hernia defect was 7 cm (range 5-12 cm). There were 5 (10.4%) seromas and 1 recurrence (2.1%) at a mean of 36 mo follow-up.
CONCLUSION The authors recommend the modified RMR as an acceptable alternative to mesh repair of ventral hernias. The seroma rate can be further reduced with routine use of drains. The modified RMR also has the benefit of eliminating all mesh-specific complications.
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Affiliation(s)
- Vijay Naraynsingh
- Department of Surgery, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago
| | - Shamir O Cawich
- Department of Surgery, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Samara Hassranah
- Department of Surgery, Medical Associate Hospital, St. Joseph, Trinidad and Tobago
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15
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Estrada Mira S, García-Briega MI, Gómez Ribelles JL, Restrepo Munera LM. Viscoelastic Properties of Acellular Matrices of Porcine Esophageal Mucosa and Comparison with Acellular Matrices of Porcine Small Intestine Submucosa and Bovine Pericardium. MATERIALS (BASEL, SWITZERLAND) 2023; 17:134. [PMID: 38203987 PMCID: PMC10779732 DOI: 10.3390/ma17010134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
The aim of this study was to compare the viscoelastic properties of a decellularized mesh from the porcine esophagus, prepared by our group, with two commercial acellular tissues derived from porcine small intestine submucosa and bovine pericardium for use in medical devices. The tissues' viscoelastic properties were characterized by creep tests in tension, applying the load in the direction of the fibers or the transverse direction, and also by dynamic-shear mechanical tests between parallel plates or in tension at frequencies between 0.1 and 35 Hz. All the tests were performed in triplicate at a constant temperature of 37 °C immersed in distilled water. The tissues' surface and cross-sectional microstructure were observed by scanning electron microscopy (SEM) to characterize the orientation of the fibers. The matrices of the porcine esophagus present an elastic modulus in the order of 60 MPa when loaded in the longitudinal direction while those of the porcine intestine submucosa and bovine pericardium have an elastic modulus below 5 MPa. Nevertheless, the shear modulus of bovine pericardium nearly triplicates that of the esophageal matrix. The viscoelasticity of decellularized esophageal mucosa is characterized by a fast change in the creep compliance with time. The slope of the creep curve in the double logarithmic plot is twice that of the control samples. These results are consistent with the microstructure observed under electron microscopy regarding the orientation of the fibers that make up the matrices.
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Affiliation(s)
- Sergio Estrada Mira
- Tissue Engineering and Cells Therapy Group (GITTC), School of Medicine, University of Antioquia, Medellin 050010, Colombia; (S.E.M.); (L.M.R.M.)
- Cell Therapy and Biobank, Alma Mater Hospital of Antioquia, University of Antioquia, Medellin 050010, Colombia
| | - María Inmaculada García-Briega
- Centre for Biomaterials and Tissue Engineering (CBIT), Universitat Politècnica de València, 46022 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Luis Gómez Ribelles
- Centre for Biomaterials and Tissue Engineering (CBIT), Universitat Politècnica de València, 46022 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Luz M. Restrepo Munera
- Tissue Engineering and Cells Therapy Group (GITTC), School of Medicine, University of Antioquia, Medellin 050010, Colombia; (S.E.M.); (L.M.R.M.)
- Cell Therapy and Biobank, Alma Mater Hospital of Antioquia, University of Antioquia, Medellin 050010, Colombia
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16
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Giacalone V, Civilini V, Audenino AL, Terzini M. Quantifying mesh textile and effective porosities: A straightforward image analysis procedure for morphological analysis of surgical meshes. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 242:107850. [PMID: 37865005 DOI: 10.1016/j.cmpb.2023.107850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Surgical meshes have demonstrated greater reliability compared to suture repair for abdominal wall hernia treatment. However, questions remain regarding the properties of these devices and their influence on surgical outcomes. Morphological properties, including pore size and porosity, play a crucial role in mesh integration and encapsulation. In this study, we introduce a straightforward image analysis procedure for accurately calculating both textile porosity and effective porosity. The latter specifically considers pores that prevent bridging, providing valuable insights into mesh performance. METHODS A photographic setup was established to capture high-quality images of the meshes, accompanied by calibration images necessary for computing the effective porosity. The developed image analysis procedure comprises seven steps focused on improving the binarization process's quality, followed by the computation of textile and effective porosities. To facilitate usability, an app called "poreScanner" was designed using MATLAB app designer, guiding users through the algorithm described herein. The app was used to compute both porosities on 24 meshes sourced from various manufacturers, by averaging seven measurements obtained from as many images. The app's measurement stability was validated computing the coefficient of variation for both textile and effective porosity, for a total of 36 results (24 for the textile porosity and 12 for the effective one). Additionally, different operators independently tested one heavy and one light mesh, confirming the measurement's operator independence. RESULTS The results on the coefficient of variation indicated values below 5 % in 34 out of 36 cases, regardless of the mesh density. Similarly, the same parameter was computed to assess the independence of the procedure from different operators, yielding a maximum value of 1.84 %. These findings confirm the robustness and user-independence of the measurement procedure. CONCLUSIONS The procedure presented in this study is straightforward to replicate and yields dependable results. Its adoption has the potential to standardize the computation of surgical mesh porosity, enabling consistent determination of this crucial morphological parameter.
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Affiliation(s)
- Vincenzo Giacalone
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin 10129, Italy; Polito(BIO)Med Lab, Politecnico di Torino, Turin 10129, Italy.
| | - Vittoria Civilini
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin 10129, Italy; Polito(BIO)Med Lab, Politecnico di Torino, Turin 10129, Italy
| | - Alberto L Audenino
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin 10129, Italy; Polito(BIO)Med Lab, Politecnico di Torino, Turin 10129, Italy
| | - Mara Terzini
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin 10129, Italy; Polito(BIO)Med Lab, Politecnico di Torino, Turin 10129, Italy
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17
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Najm A, Niculescu AG, Gaspar BS, Grumezescu AM, Beuran M. A Review of Abdominal Meshes for Hernia Repair-Current Status and Emerging Solutions. MATERIALS (BASEL, SWITZERLAND) 2023; 16:7124. [PMID: 38005054 PMCID: PMC10672379 DOI: 10.3390/ma16227124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023]
Abstract
Abdominal hernias are common issues in the clinical setting, burdening millions of patients worldwide. Associated with pain, decreased quality of life, and severe potential complications, abdominal wall hernias should be treated as soon as possible. Whether an open repair or laparoscopic surgical approach is tackled, mesh reinforcement is generally required to ensure a durable hernia repair. Over the years, numerous mesh products have been made available on the market and in clinical settings, yet each of the currently used meshes presents certain limitations that reflect on treatment outcomes. Thus, mesh development is still ongoing, and emerging solutions have reached various testing stages. In this regard, this paper aims to establish an up-to-date framework on abdominal meshes, briefly overviewing currently available solutions for hernia repair and discussing in detail the most recent advances in the field. Particularly, there are presented the developments in lightweight materials, meshes with improved attachment, antimicrobial fabrics, composite and hybrid textiles, and performant mesh designs, followed by a systematic review of recently completed clinical trials.
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Affiliation(s)
- Alfred Najm
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari, Sector 5, 050474 Bucharest, Romania; (A.N.); (B.S.G.); (M.B.)
- Emergency Hospital Floreasca Bucharest, 8 Calea Floresca, Sector 1, 014461 Bucharest, Romania
| | - Adelina-Gabriela Niculescu
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania;
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
| | - Bogdan Severus Gaspar
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari, Sector 5, 050474 Bucharest, Romania; (A.N.); (B.S.G.); (M.B.)
- Emergency Hospital Floreasca Bucharest, 8 Calea Floresca, Sector 1, 014461 Bucharest, Romania
| | - Alexandru Mihai Grumezescu
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania;
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
- Academy of Romanian Scientists, Ilfov No. 3, 050044 Bucharest, Romania
| | - Mircea Beuran
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari, Sector 5, 050474 Bucharest, Romania; (A.N.); (B.S.G.); (M.B.)
- Emergency Hospital Floreasca Bucharest, 8 Calea Floresca, Sector 1, 014461 Bucharest, Romania
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18
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Drapal V, Mosier S, Norman A, Berbel G, Robinson JL, Friis EA. A preliminary In Vitro viability study of an electrically active hernia mesh on mouse fibroblasts. J Biomater Appl 2023; 38:662-669. [PMID: 37862784 PMCID: PMC11181991 DOI: 10.1177/08853282231209312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Hernias occur when part of an organ, typically the intestines, protrudes through a disruption of the fascia in the abdominal wall, leading to patient pain, discomfort, and surgical intervention. Over one million hernia repair surgeries occur annually in the USA, but globally, hernia surgeries can exceed 20 million. Standard practice includes hernia repair mesh to help hold the compromised tissue together, depending on where the fascial disruption is located and the patient's condition. However, the recurrence rate for hernias after using the most common type of hernia mesh, synthetic, is currently high. Physiological-level electrical stimulation (ES) has shown beneficial effects in improving healing in soft tissue regeneration. Piezoelectric materials can produce low-level electrical signals from mechanical loading to help speed healing. Combining the novelty of piezo elements to create an electrically active hernia repair mesh for faster healing prospects is explored in this study through simulated transcutaneous mechanical loading of the piezo element with therapeutic ultrasound. A tissue phantom was developed using Gelatin #0 and Metamucil® to better simulate a clinical application of the therapeutic ultrasound loading modality. The cellular viability of varying ultrasound intensities and temporal effects was analyzed. Overall, minimal cytotoxicity was observed across all experimental groups during the ultrasound intensity and temporal viability studies.
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Affiliation(s)
- Victoria Drapal
- University of Kansas, Bioengineering Program, Lawrence, KS, USA
| | - Savannah Mosier
- University of Kansas, Bioengineering Program, Lawrence, KS, USA
| | - Anna Norman
- University of Kansas, Bioengineering Program, Lawrence, KS, USA
| | - German Berbel
- Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Jennifer L. Robinson
- University of Washington, Department of Orthopaedics and Sports Medicine
- University of Washington, Department of Mechanical Engineering
| | - Elizabeth A. Friis
- University of Kansas, Bioengineering Program, Lawrence, KS, USA
- University of Kansas, Department of Mechanical Engineering, Lawrence, KS, USA
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19
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Dorkhani E, Darzi B, Foroutani L, Ebrahim Soltani Z, Ahmadi Tafti SM. Characterization and in vivo evaluation of a fabricated absorbable poly(vinyl alcohol)-based hernia mesh. Heliyon 2023; 9:e22279. [PMID: 38045132 PMCID: PMC10689958 DOI: 10.1016/j.heliyon.2023.e22279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023] Open
Abstract
The most widely taken medical approach toward hernia repair involves the implementation of a prosthetic mesh to cover the herniated site and reinforce the weakened area of the abdominal wall. Biodegradable meshes can serve as biocompatible grafts with a low risk of infection. However, their major complication is associated with a high rate of degradation and hernia recurrence. We proposed a facile and cost-effective method to fabricate a poly(vinyl alcohol)-based mesh, using the solution casting technique. The inclusion of zinc oxide nanoparticles, citric acid, and three cycles of freeze-thaw were intended to ameliorate the mechanical properties of poly(vinyl alcohol). Several characterization, cell culture, and animal studies were conducted. Swelling and water contact angle measurements confirmed good water uptake capacity and wetting behavior of the final mesh sample. The synthesized mesh acquired a high mechanical strength of 52.8 MPa, and its weight loss was decreased to 39 %. No cytotoxicity was found in all samples. In vivo experiments revealed that less adhesion and granuloma formation, greater tissue integration, and notably higher neovascularization rate were resulted from implanting this fabricated hernia mesh, compared to commercial Prolene® mesh. Furthermore, the amount of collagen deposition and influential growth factors were enhanced when rats were treated with the proposed mesh instead of Prolene®.
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Affiliation(s)
- Erfan Dorkhani
- Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran
- School of Chemical Engineering, College of Engineering, University of Tehran, Tehran 1417614411, Iran
| | - Bahareh Darzi
- Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran
- School of Chemical Engineering, College of Engineering, University of Tehran, Tehran 1417614411, Iran
| | - Laleh Foroutani
- Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran
- Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran 1419733141, Iran
| | - Zahra Ebrahim Soltani
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Ahmadi Tafti
- Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran
- Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran 1419733141, Iran
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20
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Najm A, Niculescu AG, Rădulescu M, Gaspar BS, Grumezescu AM, Beuran M. Novel Material Optimization Strategies for Developing Upgraded Abdominal Meshes. Int J Mol Sci 2023; 24:14298. [PMID: 37762601 PMCID: PMC10531784 DOI: 10.3390/ijms241814298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Over 20 million hernias are operated on globally per year, with most interventions requiring mesh reinforcement. A wide range of such medical devices are currently available on the market, most fabricated from synthetic polymers. Yet, searching for an ideal mesh is an ongoing process, with continuous efforts directed toward developing upgraded implants by modifying existing products or creating innovative systems from scratch. In this regard, this review presents the most frequently employed polymers for mesh fabrication, outlining the market available products and their relevant characteristics, further focusing on the state-of-the-art mesh approaches. Specifically, we mainly discuss recent studies concerning coating application, nanomaterials addition, stem cell seeding, and 3D printing of custom mesh designs.
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Affiliation(s)
- Alfred Najm
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.N.); (B.S.G.); (M.B.)
- Emergency Hospital Floreasca Bucharest, 014461 Bucharest, Romania
| | - Adelina-Gabriela Niculescu
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania;
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
| | - Marius Rădulescu
- Department of Inorganic Chemistry, Physical Chemistry and Electrochemistry, Politehnica University of Bucharest, 011061 Bucharest, Romania;
| | - Bogdan Severus Gaspar
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.N.); (B.S.G.); (M.B.)
- Emergency Hospital Floreasca Bucharest, 014461 Bucharest, Romania
| | - Alexandru Mihai Grumezescu
- Research Institute of the University of Bucharest—ICUB, University of Bucharest, 050657 Bucharest, Romania;
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Politehnica University of Bucharest, 011061 Bucharest, Romania
- Academy of Romanian Scientists, Ilfov No. 3, 050044 Bucharest, Romania
| | - Mircea Beuran
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.N.); (B.S.G.); (M.B.)
- Emergency Hospital Floreasca Bucharest, 014461 Bucharest, Romania
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21
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dos Santos PV, Hirano ES. Experimental evaluation of the use of starch and carboxymethylcellulose in the prevention of intraperitoneal adhesions in hernia surgery with coated meshes. Acta Cir Bras 2023; 38:e383323. [PMID: 37729350 PMCID: PMC10508194 DOI: 10.1590/acb383323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/11/2023] [Indexed: 09/22/2023] Open
Abstract
PURPOSE Laparoscopic hernia repair involves a risk of adhesion between coated mesh and viscera. Plant polysaccharides such as starch and carboxymethylcellulose (SC) make up a product that acts as a barrier and prevents intraperitoneal adhesions. This study aimed to evaluate whether topical SC can also reduce adhesions between mesh and intra-abdominal organs. METHODS Forty rats each received placement of two intraperitoneal mesh fragments, one on each side of the abdominal wall. Randomly, 20 animals received SC on the right and other 20 on the left, leaving the contralateral side as a control. Fourteen days after the surgery, the animals underwent an additional laparotomy in which macroscopic analysis was performed. RESULTS As for the percentage of the mesh area affected by adhesion, one (2.6%) animal had > 75% adhesion on the experimental side, and 11 animals (28.9%) on the control side. The adhesion intensity score showed firm adhesions in three (7.9%) animals on the experimental side and nine (23.7%) on the control side. CONCLUSIONS The use of SC decreased the intensity of adhesions and the surface area of the mesh affected by adhesions. There was no negative interference of the product in the incorporation of the mesh into the abdominal wall.
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Affiliation(s)
- Paulo Vicente dos Santos
- Universidade Estadual de Campinas – Postgraduate Program in Surgical Science – Campinas SP – Brazil
| | - Elcio Shiyoiti Hirano
- Universidade Estadual de Campinas – Postgraduate Program in Surgical Science – Campinas SP – Brazil
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22
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Vasalou V, Kotidis E, Tatsis D, Boulogeorgou K, Grivas I, Koliakos G, Cheva A, Ioannidis O, Tsingotjidou A, Angelopoulos S. The Effects of Tissue Healing Factors in Wound Repair Involving Absorbable Meshes: A Narrative Review. J Clin Med 2023; 12:5683. [PMID: 37685753 PMCID: PMC10488606 DOI: 10.3390/jcm12175683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/17/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
Wound healing is a complex and meticulously orchestrated process involving multiple phases and cellular interactions. This narrative review explores the intricate mechanisms behind wound healing, emphasizing the significance of cellular processes and molecular factors. The phases of wound healing are discussed, focusing on the roles of immune cells, growth factors, and extracellular matrix components. Cellular shape alterations driven by cytoskeletal modulation and the influence of the 'Formin' protein family are highlighted for their impact on wound healing processes. This review delves into the use of absorbable meshes in wound repair, discussing their categories and applications in different surgical scenarios. Interleukins (IL-2 and IL-6), CD31, CD34, platelet rich plasma (PRP), and adipose tissue-derived mesenchymal stem cells (ADSCs) are discussed in their respective roles in wound healing. The interactions between these factors and their potential synergies with absorbable meshes are explored, shedding light on how these combinations might enhance the healing process. Recent advances and challenges in the field are also presented, including insights into mesh integration, biocompatibility, infection prevention, and postoperative complications. This review underscores the importance of patient-specific factors and surgical techniques in optimizing mesh placement and healing outcomes. As wound healing remains a dynamic field, this narrative review provides a comprehensive overview of the current understanding and potential avenues for future research and clinical applications.
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Affiliation(s)
- Varvara Vasalou
- Fourth Surgical Department, School of Medicine, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece
- Andreas Syggros Hospital, 11528 Athens, Greece
| | - Efstathios Kotidis
- Fourth Surgical Department, School of Medicine, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece
| | - Dimitris Tatsis
- Fourth Surgical Department, School of Medicine, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece
- Oral and Maxillofacial Surgery Department, School of Dentistry, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece
| | - Kassiani Boulogeorgou
- Department of Pathology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.B.)
| | - Ioannis Grivas
- Laboratory of Anatomy, Histology & Embryology, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Georgios Koliakos
- Department of Biochemistry, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Angeliki Cheva
- Department of Pathology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (K.B.)
| | - Orestis Ioannidis
- Fourth Surgical Department, School of Medicine, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece
| | - Anastasia Tsingotjidou
- Laboratory of Anatomy, Histology & Embryology, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Stamatis Angelopoulos
- Fourth Surgical Department, School of Medicine, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece
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23
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Zareei A, Kasi V, Thornton A, Rivera UH, Sawale M, Maruthamuthu MK, He Z, Nguyen J, Wang H, Mishra DK, Rahimi R. Non-destructive processing of silver containing glass ceramic antibacterial coating on polymeric surgical mesh surfaces. NANOSCALE 2023; 15:11209-11221. [PMID: 37345366 PMCID: PMC10552273 DOI: 10.1039/d3nr01317k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Surgical meshes composed of bioinert polymers such as polypropylene are widely used in millions of hernia repair procedures to prevent the recurrence of organ protrusion from the damaged abdominal wall. However, post-operative mesh infection remains a significant complication, elevating hernia recurrence risks from 3.6% to 10%, depending on the procedure type. While attempts have been made to mitigate these infection-related complications by using antibiotic coatings, the rise in antibiotic-resistant bacterial strains threatens their effectiveness. Bioactive glass-ceramics featuring noble metals, notably silver nanoparticles (AgNPs), have recently gained traction for their wide antibacterial properties and biocompatibility. Yet, conventional methods of synthesizing and coating of such materials often require high temperatures, thus making them impractical to be implemented on temperature-sensitive polymeric substrates. To circumvent this challenge, a unique approach has been explored to deposit these functional compounds onto temperature-sensitive polypropylene mesh (PP-M) surfaces. This approach is based on the recent advancements in cold atmospheric plasma (CAP) assisted deposition of SiO2 thin films and laser surface treatment (LST), enabling the selective heating and formation of functional glass-ceramic compounds under atmospheric conditions. A systematic study was conducted to identify optimal LST conditions that resulted in the effective formation of a bioactive glass-ceramic structure without significantly altering the chemical and mechanical properties of the underlying PP-M (less than 1% change compared to the original properties). The developed coating with optimized processing conditions demonstrated high biocompatibility and persistent antibacterial properties (>7 days) against both Gram-positive and Gram-negative bacteria. The developed process is expected to provide a new stepping stone towards depositing a wide range of functional bioceramic coatings onto different implant surfaces, thereby decreasing their risk of infection and associated complications.
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Affiliation(s)
- Amin Zareei
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Canter, Purdue University, West Lafayette, IN 47907, USA
| | - Venkat Kasi
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Canter, Purdue University, West Lafayette, IN 47907, USA
| | - Allison Thornton
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Canter, Purdue University, West Lafayette, IN 47907, USA
| | - Ulisses Heredia Rivera
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Canter, Purdue University, West Lafayette, IN 47907, USA
| | - Manoj Sawale
- Department of Food Science, Purdue University, West Lafayette, IN 47907, USA
| | - Murali Kannan Maruthamuthu
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Zihao He
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Juliane Nguyen
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Haiyan Wang
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Dharmendra K Mishra
- Department of Food Science, Purdue University, West Lafayette, IN 47907, USA
| | - Rahim Rahimi
- School of Materials Engineering, Purdue University, West Lafayette, IN 47907, USA.
- Birck Nanotechnology Canter, Purdue University, West Lafayette, IN 47907, USA
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
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Schluck M, Weiden J, Verdoes M, Figdor CG. Insights in the host response towards biomaterial-based scaffolds for cancer therapy. Front Bioeng Biotechnol 2023; 11:1149943. [PMID: 37342507 PMCID: PMC10277494 DOI: 10.3389/fbioe.2023.1149943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023] Open
Abstract
Immunotherapeutic strategies have shown promising results in the treatment of cancer. However, not all patients respond, and treatments can have severe side-effects. Adoptive cell therapy (ACT) has shown remarkable therapeutic efficacy across different leukaemia and lymphoma types. But the treatment of solid tumours remains a challenge due to limited persistence and tumour infiltration. We believe that biomaterial-based scaffolds are promising new tools and may address several of the challenges associated with cancer vaccination and ACT. In particular, biomaterial-based scaffold implants allow for controlled delivery of activating signals and/or functional T cells at specific sites. One of the main challenges for their application forms the host response against these scaffolds, which includes unwanted myeloid cell infiltration and the formation of a fibrotic capsule around the scaffold, thereby limiting cell traffic. In this review we provide an overview of several of the biomaterial-based scaffolds designed for cancer therapy to date. We will discuss the host responses observed and we will highlight design parameters that influence this response and their potential impact on therapeutic outcome.
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Affiliation(s)
- Marjolein Schluck
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, Netherlands
- Oncode Institute, Nijmegen, Netherlands
- Institute for Chemical Immunology, Nijmegen, Netherlands
| | - Jorieke Weiden
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, Netherlands
- Oncode Institute, Nijmegen, Netherlands
- Institute for Chemical Immunology, Nijmegen, Netherlands
| | - Martijn Verdoes
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, Netherlands
- Institute for Chemical Immunology, Nijmegen, Netherlands
| | - Carl G. Figdor
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, Netherlands
- Oncode Institute, Nijmegen, Netherlands
- Institute for Chemical Immunology, Nijmegen, Netherlands
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25
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Alansari AH, Almalawi AM, Alghamdi A, Alghamdi MS, Hazazi HA, Aljabri AA, Alsulami RA, Alkhoshi AM, Khinaifis F. Body Mass Index Within Multifactor Predictors of Ventral Hernia Recurrence: A Retrospective Cohort Study. Cureus 2023; 15:e41148. [PMID: 37519520 PMCID: PMC10386881 DOI: 10.7759/cureus.41148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Background A ventral hernia is a protrusion of the peritoneum through the defective abdominal wall. Several risk factors increase the likelihood of hernial recurrence. One of the most common risk factors is obesity, defined by the World Health Organization (WHO) as increased body mass index (BMI). Few studies have explored the effects of BMI and other factors on hernia recurrence. Hence, we aimed to investigate the role of increased BMI in hernia recurrence in conjunction with various risk factors such as age, sex, type of hernia, the time elapsed between the occurrence and recurrence, complications of hernia, and procedure. Methods This retrospective cohort study was conducted at King Abdulaziz University Hospital (KAUH). All the patients were admitted between 2015-2022. A total of 1676 medical records were obtained from all patients who underwent hernia repair more than once or were diagnosed with a recurrent hernia during the study period. Results Our study revealed an insignificant correlation between a BMI of more than 25 kg/m2 and the recurrence of inguinal hernias, predominantly indirect hernias. Furthermore, overweight and obese patients experience a longer interval between the first and second hernia repairs. Interestingly, all the patients with inguinal and umbilical hernias had the same diagnosis at the second presentation. However, the findings also included a significant increase in umbilical hernias in individuals with a high BMI and higher recurrence rates among male patients with inguinal hernias. Conclusion BMI higher than 25 kg/m2 increases recurrence rates for umbilical hernias but decreases the recurrence of inguinal hernias.
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Affiliation(s)
| | - Asim M Almalawi
- Infectious Diseases, King Abdulaziz University Hospital, Jeddah, SAU
| | - Abdullah Alghamdi
- Infectious Diseases, King Abdulaziz University Hospital, Jeddah, SAU
| | | | - Hassan A Hazazi
- Infectious Diseases, King Abdulaziz University Hospital, Jeddah, SAU
| | | | - Raed A Alsulami
- Internal Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | | | - Fatma Khinaifis
- Surgical Oncology, King Abdulaziz University Hospital, Jeddah, SAU
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26
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Götz A, Senz V, Schmidt W, Koper D, Grabow N, Illner S. Detection of acoustic emission from nanofiber nonwovens under tensile strain - An ultrasonic test setup for critical medical device components. J Mech Behav Biomed Mater 2023; 140:105720. [PMID: 36801776 DOI: 10.1016/j.jmbbm.2023.105720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023]
Abstract
In the biomedical field, nanofiber materials are gaining increasing application. For material characterization of nanofiber fabrics, tensile testing and scanning electron microscopy (SEM) are established standards. However, tensile tests provide information about the entire sample without information about single fibers. Conversely, SEM images examine individual fibers, but cover only a small section near the surface of the sample. To gain information on failure at the fiber level under tensile stress, recording of acoustic emission (AE) is a promising method, but challenging due to weak signal intensity. Using AE recording, beneficial findings can be obtained even on "invisible" material failure without affecting tensile tests. In this work, a technology for recording weak ultrasonic AE of tearing nanofiber nonwovens is presented, which uses a highly sensitive sensor. Functional proof of the method using biodegradable PLLA nonwoven fabrics is provided. The potential benefit is demonstrated by unmasking significant AE intensity in an almost imperceptible bend in the stress-strain curve of a nonwoven fabric. AE recording has not yet been performed on standard tensile tests of unembedded nanofiber material intended for safety-related medical applications. The technology has the potential to enrich the spectrum of testing methods, even those not confined to medical field.
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Affiliation(s)
- Andreas Götz
- Institute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Str. 4, 18119, Rostock, Germany.
| | - Volkmar Senz
- Institute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Str. 4, 18119, Rostock, Germany.
| | - Wolfram Schmidt
- Institute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Str. 4, 18119, Rostock, Germany.
| | - Daniela Koper
- Institute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Str. 4, 18119, Rostock, Germany.
| | - Niels Grabow
- Institute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Str. 4, 18119, Rostock, Germany.
| | - Sabine Illner
- Institute for Biomedical Engineering, University Medical Center Rostock, Friedrich-Barnewitz-Str. 4, 18119, Rostock, Germany.
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27
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Ben H, Kholinne E, Zeng CH, So SP, Lee JB, Sun Y, Koh KH, Jeon IH. Early Postoperative MRI Evaluation of a Fascia Lata Autograft With and Without Polypropylene Mesh Augmentation After Superior Capsular Reconstruction. Am J Sports Med 2023; 51:912-918. [PMID: 36786289 DOI: 10.1177/03635465231151927] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Recently, a polypropylene mesh has been introduced and reported to improve clinical outcomes after superior capsular reconstruction (SCR) using a fascia lata autograft (FLA). However, mesh-related events such as a foreign body response may trigger inflammation, which might affect graft healing and remodeling. PURPOSE/HYPOTHESIS The aim was to investigate whether the healing and remodeling of an FLA were affected by the use of a mesh by comparing the signal intensity of an FLA-alone group vs an FLA + Mesh group on postoperative magnetic resonance imaging (MRI). The hypothesis was that the use of a mesh would decrease the MRI signal intensity of FLA during the early postoperative phase. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Patients who had undergone SCR using an FLA with or without a mesh between March 2013 and August 2021 were retrospectively analyzed. Follow-up MRI was performed at 3 months. A total of 78 patients (24 in the FLA group and 54 in the FLA + Mesh group) with intact grafts were included. Graft remodeling was evaluated by analyzing the signal-to-noise quotient (SNQ) at the humeral, mid-substance, and glenoid sites. Theoretically, lower SNQ ratios indicate higher strength and better healing of the graft. RESULTS The mean SNQ was 30.603 (range, 11.790-72.710) in the FLA group and 18.367 (range, 4.464-69.500) in the FLA + Mesh group (P < .001). Furthermore, significant differences were found between the 2 groups at the humeral and mid-substance sites (37.863 [range, 5.092-81.187] vs 15.512 [range, 1.814-80.869], P < .001; and 29.168 [range, 6.103-73.900] vs 16.878 [range, 2.454-92.416], P = .003; respectively). However, there was no difference between the 2 groups at the glenoid site (25.346 [range, 7.565-86.353] vs 20.354 [range, 3.732-88.468], P = .057). CONCLUSION At the 3-month follow-up, the FLA + Mesh group showed a lower MRI signal intensity than the FLA group. The healing and remodeling of an FLA may be enhanced when a mesh is used.
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Affiliation(s)
- Hui Ben
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Erica Kholinne
- Faculty of Medicine, Universitas Trisakti, Department of Orthopedic Surgery, St Carolus Hospital, Jakarta, Indonesia
| | - Chu Hui Zeng
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Pil So
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun-Bum Lee
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yucheng Sun
- Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Kyoung-Hwan Koh
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - In-Ho Jeon
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Fontana-Escartín A, El Hauadi K, Lanzalaco S, Pérez-Madrigal MM, Armelin E, Turon P, Alemán C. Preparation and Characterization of Functionalized Surgical Meshes for Early Detection of Bacterial Infections. ACS Biomater Sci Eng 2023; 9:1104-1115. [PMID: 36693280 PMCID: PMC10889595 DOI: 10.1021/acsbiomaterials.2c01319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Isotactic polypropylene (i-PP) nonabsorbable surgical meshes are modified by incorporating a conducting polymer (CP) layer to detect the adhesion and growth of bacteria by sensing the oxidation of nicotinamide adenine dinucleotide (NADH), a metabolite produced by the respiration reactions of such microorganisms, to NAD+. A three-step process is used for such incorporation: (1) treat pristine meshes with low-pressure O2 plasma; (2) functionalize the surface with CP nanoparticles; and (3) coat with a homogeneous layer of electropolymerized CP using the nanoparticles introduced in (2) as polymerization nuclei. The modified meshes are stable and easy to handle and also show good electrochemical response. The detection by cyclic voltammetry of NADH within the interval of concentrations reported for bacterial cultures is demonstrated for the two modified meshes. Furthermore, Staphylococcus aureus and both biofilm-positive (B+) and biofilm-negative (B-) Escherichia coli cultures are used to prove real-time monitoring of NADH coming from aerobic respiration reactions. The proposed strategy, which offers a simple and innovative process for incorporating a sensor for the electrochemical detection of bacteria metabolism to currently existing surgical meshes, holds considerable promise for the future development of a new generation of smart biomedical devices to fight against post-operative bacterial infections.
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Affiliation(s)
- Adrián Fontana-Escartín
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya, C/ Eduard Maristany, 10-14, 08019Barcelona, Spain
| | - Karima El Hauadi
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya, C/ Eduard Maristany, 10-14, 08019Barcelona, Spain
| | - Sonia Lanzalaco
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya, C/ Eduard Maristany, 10-14, 08019Barcelona, Spain
| | - Maria M Pérez-Madrigal
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya, C/ Eduard Maristany, 10-14, 08019Barcelona, Spain
| | - Elaine Armelin
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya, C/ Eduard Maristany, 10-14, 08019Barcelona, Spain
| | - Pau Turon
- B. Braun Surgical, S.A.U., Carretera de Terrassa 121, 08191Rubí (Barcelona), Spain
| | - Carlos Alemán
- Departament d'Enginyeria Química and Barcelona Research Center for Multiscale Science and Engineering, EEBE, Universitat Politècnica de Catalunya, C/ Eduard Maristany, 10-14, 08019Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Baldiri Reixac 10-12, 08028Barcelona, Spain
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29
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Maspero M, Heilman J, Otero Piñeiro A, Steele SR, Hull TL. Techniques of perineal hernia repair: A systematic review and meta-analysis. Surgery 2023; 173:312-321. [PMID: 36404179 DOI: 10.1016/j.surg.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Perineal hernias are rare, underreported and poorly studied complications of extensive pelvic surgeries. Their management is challenging, with currently no treatment algorithm available. METHOD MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were searched. Studies comprising at least 3 patients who underwent surgical perineal hernia repair were included. The primary outcome was perineal hernia recurrence. The secondary outcomes were overall complications and surgical site occurrences. RESULTS Twenty-nine studies were included, comprising 325 patients undergoing 347 repairs. Overall complications were 33% (95% confidence interval 24%-43%) in the entire cohort, 31% (19%-44%) after perineal repair, 39% (14%-67%) after abdominal repair, and 36% (19%-53%) after mesh repair (20% with biological, 46% with synthetic mesh). The surgical site occurrence rate was 18% (8%-29%). The overall recurrence rate was 22% (15%-29%). Recurrence after perineal repair was 19% (10%-29%): 20% with mesh (25% with biological, 19% with synthetic), 24% with primary repair, and 39% with flap repair. Recurrence after an abdominal repair was 18% (11%-26%): 16% with laparoscopic, 12% with open, 16% with mesh (24% with biological, 16% with synthetic), 30% with primary, and 25% with flap repair. No significant differences could be found in the meta-analysis regarding overall complications and recurrence. CONCLUSION Synthetic mesh repair seems to be associated with a lower recurrence rate than other techniques, especially after an abdominal approach. The perineal and abdominal approaches appear to be safe, with similar recurrence rates. The combined approach seems promising, but more evidence is needed.
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Affiliation(s)
- Marianna Maspero
- Department of Colon and Rectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, OH. http://www.twitter.com/MariannaMaspero
| | - Jaclyn Heilman
- General Surgery, Jefferson Health-Abington, Abington, PA
| | - Ana Otero Piñeiro
- Department of Colon and Rectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, OH. http://www.twitter.com/AnaOtero_MD
| | - Scott R Steele
- Department of Colon and Rectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, OH. http://www.twitter.com/ScottRSteeleMD
| | - Tracy L Hull
- Department of Colon and Rectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, OH.
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30
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Voniatis C, Závoti O, Manikion K, Budavári B, Hajdu AJ. Fabrication of Mechanically Enhanced, Suturable, Fibrous Hydrogel Membranes. MEMBRANES 2023; 13:116. [PMID: 36676923 PMCID: PMC9867240 DOI: 10.3390/membranes13010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Poly(vinyl-alcohol) hydrogels have already been successfully utilised as drug carrier systems and tissue engineering scaffolds. However, lacking mechanical strength and suturability hinders any prospects for clinical and surgical applications. The objective of this work was to fabricate mechanically robust PVA membranes, which could also withstand surgical manipulation and suturing. Electrospun membranes and control hydrogels were produced with 61 kDa PVA. Using a high-speed rotating cylindrical collector, we achieved fibre alignment (fibre diameter: 300 ± 50 nm). Subsequently, we created multilayered samples with different orientations to achieve multidirectional reinforcement. Finally, utilising glutaraldehyde as a cross-linker, we created insoluble fibrous-hydrogel membranes. Mechanical studies were performed, confirming a fourfold increase in the specific loading capacities (from 0.21 to 0.84 Nm2/g) in the case of the monolayer samples. The multilayered membranes exhibited increased resistance from both horizontal and vertical directions, which varies according to the specific arrangement. Finally, the cross-linked fibrous hydrogel samples not only exhibited specific loading capacities significantly higher than their counterpart bulk hydrogels but successfully withstood suturing. Although cross-linking optimisation and animal experiments are required, these membranes have great prospects as alternatives to current surgical meshes, while the methodology could also be applied in other systems as well.
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Affiliation(s)
- Constantinos Voniatis
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, 1082 Budapest, Hungary
- Laboratory of Nanochemistry, Department of Biophysics and Radiation Biology, Semmelweis University, 1085 Budapest, Hungary
| | - Olivér Závoti
- Laboratory of Nanochemistry, Department of Biophysics and Radiation Biology, Semmelweis University, 1085 Budapest, Hungary
| | - Kenigen Manikion
- Laboratory of Nanochemistry, Department of Biophysics and Radiation Biology, Semmelweis University, 1085 Budapest, Hungary
| | - Bálint Budavári
- Laboratory of Nanochemistry, Department of Biophysics and Radiation Biology, Semmelweis University, 1085 Budapest, Hungary
| | - Angela Jedlovszky Hajdu
- Laboratory of Nanochemistry, Department of Biophysics and Radiation Biology, Semmelweis University, 1085 Budapest, Hungary
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Qiao Y, Zhang Q, Wang Q, Li Y, Wang L. Chrysanthemum–like hierarchitectures decorated on polypropylene hernia mesh and their anti-inflammatory effects. JOURNAL OF POLYMER RESEARCH 2023. [DOI: 10.1007/s10965-022-03386-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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32
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Skriabin AS, Shakurov AV, Vesnin VR, Lukina YS, Tsygankov PA, Bionyshev-Abramov LL, Serejnikova NB, Vorob’ev EV. Titanium Membranes with Hydroxyapatite/Titania Bioactive Ceramic Coatings: Characterization and In Vivo Biocompatibility Testing. ACS OMEGA 2022; 7:47880-47891. [PMID: 36591210 PMCID: PMC9798509 DOI: 10.1021/acsomega.2c05718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/01/2022] [Indexed: 06/12/2023]
Abstract
Titanium membranes and meshes are used for the repair of trauma, tumors, and hernia in dentistry and maxillofacial and abdominal surgery. But such membranes demonstrate the limited effectiveness of integration in recipients due to their bioinertness. In this study, we prepared titania oxide (by microarc oxidation) and/or HAp (by electrophoresis deposition) coatings with alginate soaking. We used annealing at 700 °C for 2.5 h for HAp crystallinity increasing with achievement of an acceptable Ca2+ release rate. The feedstock HAp and prepared coatings were characterized by X-ray diffraction, IR spectroscopy, electron and optical confocal microscopy, and thermal analysis, as well as the in vitro study of solubility in saline and in vivo tests with the animal model of subcutaneous implantation (with Wistar rats). Biocompatible compounds were found for all deposited coatings. We noted that the best biological response was detected for the annealed Ca-P/TiO2 bilayer with alginate binding. In this case, the coating crystallinity was ≈40.5-50.0%. The Ca2+ release rate was 2.042 ± 0.058%/mm2 at 168 h after immersion in saline. Thin and mature tissue capsules with minimal inflammation and vascularization were found in histological sections. We did not detect any unwanted responses around the implants, including inflammation infiltration, suppuration, bacterial infections, tissue lyses, and, finally, implant rejection. This information is expected to be useful for understanding the properties of bioactive ceramic coatings and improving the quality of medical care in dentistry and maxillofacial surgery and other applications of titanium membranes in medicine.
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Affiliation(s)
- Andrei S. Skriabin
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
| | - Alexey V. Shakurov
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
| | - Vladimir R. Vesnin
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
| | - Yulia S. Lukina
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
- FSBI
National Medical Research Center for Traumatology and Orthopedics
named after N N Priorov of the Ministry of Health of the Russian Federation, Priorova 10, Moscow127299, Russia
| | - Petr A. Tsygankov
- Universidad
Industrial de Santander, Carrera 27 # Calle 9, Bucaramanga68000, Colombia
| | - Leonid L. Bionyshev-Abramov
- FSBI
National Medical Research Center for Traumatology and Orthopedics
named after N N Priorov of the Ministry of Health of the Russian Federation, Priorova 10, Moscow127299, Russia
| | - Natalya B. Serejnikova
- I
M Sechenov First Moscow State Medical University Institute of Regenerative
Medicine, Trubetskaya,
8, Moscow119991, Russia
| | - Evgeny V. Vorob’ev
- Bauman
Moscow State Technical University National Research University of
Technology, 2-Ya Baumanskaya 5, Moscow105005, Russia
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Iroegbu AC, Ray SS. Nanocellulosics in Transient Technology. ACS OMEGA 2022; 7:47547-47566. [PMID: 36591168 PMCID: PMC9798511 DOI: 10.1021/acsomega.2c05848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
Envisage a world where discarded electrical/electronic devices and single-use consumables can dematerialize and lapse into the environment after the end-of-useful life without constituting health and environmental burdens. As available resources are consumed and human activities build up wastes, there is an urgency for the consolidation of efforts and strategies in meeting current materials needs while assuaging the concomitant negative impacts of conventional materials exploration, usage, and disposal. Hence, the emerging field of transient technology (Green Technology), rooted in eco-design and closing the material loop toward a friendlier and sustainable materials system, holds enormous possibilities for assuaging current challenges in materials usage and disposability. The core requirements for transient materials are anchored on meeting multicomponent functionality, low-cost production, simplicity in disposability, flexibility in materials fabrication and design, biodegradability, biocompatibility, and environmental benignity. In this regard, biorenewables such as cellulose-based materials have demonstrated capacity as promising platforms to fabricate scalable, renewable, greener, and efficient materials and devices such as membranes, sensors, display units (for example, OLEDs), and so on. This work critically reviews the recent progress of nanocellulosic materials in transient technologies toward mitigating current environmental challenges resulting from traditional material exploration, usage, and disposal. While spotlighting important fundamental properties and functions in the material selection toward practicability and identifying current difficulties, we propose crucial research directions in advancing transient technology and cellulose-based materials in closing the loop for conventional materials and sustainability.
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Affiliation(s)
- Austine
Ofondu Chinomso Iroegbu
- Department
of Chemical Sciences, University of Johannesburg, Doornfontein, Johannesburg 2028, South Africa
- Centre
for Nanostructures and Advanced Materials, DSI-CSIR Nanotechnology
Innovation Centre, Council for Scientific
& Industrial Research, CSIR, Pretoria 0001, South Africa
| | - Suprakas Sinha Ray
- Department
of Chemical Sciences, University of Johannesburg, Doornfontein, Johannesburg 2028, South Africa
- Centre
for Nanostructures and Advanced Materials, DSI-CSIR Nanotechnology
Innovation Centre, Council for Scientific
& Industrial Research, CSIR, Pretoria 0001, South Africa
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Sivaraj D, Fischer KS, Kim TS, Chen K, Tigchelaar SS, Trotsyuk AA, Gurtner GC, Lee GK, Henn D, Nazerali RS. Outcomes of Biosynthetic and Synthetic Mesh in Ventral Hernia Repair. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4707. [PMID: 36530858 PMCID: PMC9746774 DOI: 10.1097/gox.0000000000004707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 06/17/2023]
Abstract
The introduction of mesh for reinforcement of ventral hernia repair (VHR) led to a significant reduction in hernia recurrence rates. However, it remains controversial whether synthetic or biologic mesh leads to superior outcomes. Recently, hybrid mesh consisting of reinforced biosynthetic ovine rumen (RBOR) has been developed and aims to combine the advantages of biologic and synthetic mesh; however, outcomes after VHR with RBOR have not yet been compared with the standard of care. Methods We performed a retrospective analysis on 109 patients, who underwent VHR with RBOR (n = 50) or synthetic polypropylene mesh (n = 59). Demographic characteristics, comorbidities, postoperative complications, and recurrence rates were analyzed and compared between the groups. Multivariate logistic regression models were fit to assess associations of mesh type with overall complications and surgical site occurrence (SSO). Results Patients who underwent VHR with RBOR were older (mean age 63.7 versus 58.8 years, P = 0.02) and had a higher rate of renal disease (28.0 versus 10.2%, P = 0.01) compared with patients with synthetic mesh. Despite an unfavorable risk profile, patients with RBOR had lower rates of SSO (16.0 versus 30.5%, P = 0.12) and similar hernia recurrence rates (4.0 versus 6.78%, P = 0.68) compared with patients with synthetic mesh. The use of synthetic mesh was significantly associated with higher odds for overall complications (3.78, P < 0.05) and SSO (3.87, P < 0.05). Conclusion Compared with synthetic polypropylene mesh, the use of RBOR for VHR mitigates SSO while maintaining low hernia recurrence rates at 30-month follow-up.
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Affiliation(s)
- Dharshan Sivaraj
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Katharina S. Fischer
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Trudy S. Kim
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Kellen Chen
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Seth S. Tigchelaar
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Artem A. Trotsyuk
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Geoffrey C. Gurtner
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Gordon K. Lee
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Dominic Henn
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
| | - Rahim S. Nazerali
- From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif
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35
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Jalalah M, Ahmad A, Saleem A, Qadir MB, Khaliq Z, Khan MQ, Nazir A, Faisal M, Alsaiari M, Irfan M, Alsareii SA, Harraz FA. Electrospun Nanofiber/Textile Supported Composite Membranes with Improved Mechanical Performance for Biomedical Applications. MEMBRANES 2022; 12:membranes12111158. [PMID: 36422150 PMCID: PMC9693054 DOI: 10.3390/membranes12111158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/03/2022] [Accepted: 11/11/2022] [Indexed: 05/27/2023]
Abstract
Textile-supported nanocomposite as a scaffold has been extensively used in the medical field, mainly to give support to weak or harmed tissues. However, there are some challenges in fabricating the nanofiber/textile composite, i.e., suitable porous structure with defined pore size, less skin contact area, biocompatibility, and availability of degradable materials. Herein, polyamide-6 (PA) nanofibers were synthesized using needleless electrospinning with the toothed wheel as a spinneret. The electrospinning process was optimized using different process and solution parameters. In the next phase, optimized PA nanofiber membranes of optimum fiber diameter with uniform distribution and thickness were used in making nanofiber membrane-textile composite. Different textile fabrics (woven, non-woven, knitted) were developed. The optimized nanofiber membranes were combined with non-woven, woven, and knitted fabrics to make fabric-supported nanocomposite. The nanofiber/fabric composites were compared with available market woven and knitted meshes for mechanical properties, morphology, structure, and chemical interaction analysis. It was found that the tear strength of the nanofiber/woven composite was three times higher than market woven mesh, and the nanofiber/knitted composite was 2.5 times higher than market knitted mesh. The developed composite structures with woven and knitted fabric exhibited improved bursting strength (613.1 and 751.1 Kpa), tensile strength (195.76 and 227.85 N), and puncture resistance (68.76 and 57.47 N), respectively, than market available meshes. All these properties showed that PA nanofibers/textile structures could be utilized as a composite with multifunctional properties.
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Affiliation(s)
- Mohammed Jalalah
- Promising Centre for Sensors and Electronic Devices (PCSED), Advanced Materials and Nano-Research Centre, Najran University, Najran 11001, Saudi Arabia
- Department of Electrical Engineering, College of Engineering, Najran University, Najran 61441, Saudi Arabia
| | - Adnan Ahmad
- Department of Textile Engineering, National Textile University, Faisalabad 37610, Pakistan
| | - Asad Saleem
- Department of Textile Engineering, National Textile University, Faisalabad 37610, Pakistan
| | - Muhammad Bilal Qadir
- Department of Textile Engineering, National Textile University, Faisalabad 37610, Pakistan
| | - Zubair Khaliq
- Department of Materials, National Textile University, Faisalabad 37610, Pakistan
| | - Muhammad Qamar Khan
- Department of Textile & Clothing, Karachi Campus, National Textile University, Karachi 74900, Pakistan
| | - Ahsan Nazir
- Department of Textile Engineering, National Textile University, Faisalabad 37610, Pakistan
| | - M. Faisal
- Department of Chemistry, Faculty of Science and Arts, Najran University, Najran 11001, Saudi Arabia
| | - Mabkhoot Alsaiari
- Promising Centre for Sensors and Electronic Devices (PCSED), Advanced Materials and Nano-Research Centre, Najran University, Najran 11001, Saudi Arabia
- Department of Chemistry, Faculty of Science and Arts at Sharurah, Najran University, Najran 11001, Saudi Arabia
| | - Muhammad Irfan
- Department of Electrical Engineering, College of Engineering, Najran University, Najran 61441, Saudi Arabia
| | - S. A. Alsareii
- Promising Centre for Sensors and Electronic Devices (PCSED), Advanced Materials and Nano-Research Centre, Najran University, Najran 11001, Saudi Arabia
- Department of Surgery, College of Medicine, Najran University, Najran 11001, Saudi Arabia
| | - Farid A. Harraz
- Promising Centre for Sensors and Electronic Devices (PCSED), Advanced Materials and Nano-Research Centre, Najran University, Najran 11001, Saudi Arabia
- Department of Chemistry, Faculty of Science and Arts at Sharurah, Najran University, Najran 11001, Saudi Arabia
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36
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Mahjoubi MF, Essid N, Rezgui B, Zran M, Haouet K, Ben Moussa M. When a polyester mesh causes an enterocutaneous fistula, 30 years after its implantation. Clin Case Rep 2022; 10:e6519. [PMID: 36381028 PMCID: PMC9653162 DOI: 10.1002/ccr3.6519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 11/15/2022] Open
Abstract
Digestive fistula on mesh is an exceptional and late complication of hernioplasty. The type of mesh and its position are often implicated in its occurrence. Clinical presentation is multiform. Morphological examinations are essential to confirm the diagnosis, and the curative treatment remains surgical.
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Affiliation(s)
- Mohamed Farès Mahjoubi
- Department of Surgery A Charles Nicolle Hospital Tunis Tunisia
- Faculty of Medicine of Tunis University Tunis El Manar Tunis Tunisia
| | - Nada Essid
- Department of Surgery A Charles Nicolle Hospital Tunis Tunisia
- Faculty of Medicine of Tunis University Tunis El Manar Tunis Tunisia
| | - Bochra Rezgui
- Department of Surgery A Charles Nicolle Hospital Tunis Tunisia
- Faculty of Medicine of Tunis University Tunis El Manar Tunis Tunisia
| | - Mohamed Zran
- Faculty of Medicine of Tunis University Tunis El Manar Tunis Tunisia
- Department of Pathology Charles Nicolle Hospital Tunis Tunisia
| | - Karim Haouet
- Department of Surgery A Charles Nicolle Hospital Tunis Tunisia
- Faculty of Medicine of Tunis University Tunis El Manar Tunis Tunisia
| | - Mounir Ben Moussa
- Department of Surgery A Charles Nicolle Hospital Tunis Tunisia
- Faculty of Medicine of Tunis University Tunis El Manar Tunis Tunisia
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37
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Chen J, Glasgow RE. What is the Best Inguinal Hernia Repair? Adv Surg 2022; 56:247-258. [PMID: 36096570 DOI: 10.1016/j.yasu.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
As the management of inguinal hernias have evolved over hundreds of years, so too has our paradigm of what constitutes the "best repair." To best answer what the ideal inguinal hernia repair is, the authors take an in-depth look at considerations to the patient, the provider, and the health care system.
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Affiliation(s)
- Jennwood Chen
- Univeristy of Utah, Department of Surgery, 50 Medical Dr N, Salt Lake City, UT 84132, USA; Veterans Affairs, Department of Surgery, 550 Foothill Dr, Salt Lake City, UT 84113, USA.
| | - Robert E Glasgow
- Univeristy of Utah, Department of Surgery, 50 Medical Dr N, Salt Lake City, UT 84132, USA; Huntsman Cancer Institute, 1950 Circle of Hope, Salt Lake City, UT 84112, USA.
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38
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Wlodarczyk J, Musial-Kulik M, Jelonek K, Stojko M, Karpeta-Jarzabek P, Pastusiak M, Janeczek H, Dobrzynski P, Sobota M, Kasperczyk J. Dual-jet electrospun PDLGA/PCU nonwovens as promising mesh implant materials with controlled release of sirolimus and diclofenac. Int J Pharm 2022; 625:122113. [PMID: 35973592 DOI: 10.1016/j.ijpharm.2022.122113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022]
Abstract
Dual-jet electrospinning was employed to produce two-component, partially degradable drug releasing nonwovens with interlacing of poly(D,L-lactide-co-glycolide) (PDLGA) and different poly(carbonate urethanes) (PCUs). Diclofenac sodium and sirolimus were released simultaneously from the copolyester carrier. The research focused on determining of release profiles of drugs, depending on the hydrophilicity of introduced PCU nanofibers. The influence of drugs incorporation on the hydrolytic degradation of the PDLGA and mechanical properties of nonwovens was also studied. Evaluation for interaction with cells in vitro was investigated on a fibroblast cell line in cytotoxicity and surface adhesion tests. Significant changes in drugs release rate, depending on the applied PCU were observed. It was also noticed, that hydrophilicity of drugs significantly influenced the hydrolytic degradation mechanism and surface erosion of the PDLGA, as well as the tensile strength of nonwovens. Tests carried out on cells in an in vitro experiment showed that introduction of sirolimus caused a slight reduction in the viability of fibroblasts as well as a strong limitation in their capability to colonize the surface of fibers. Due to improvement of mechanical strength and the ability to controlled drugs release, the obtained material may be considered as prospect surgical mesh implant in the treatment of hernia.
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Affiliation(s)
- Jakub Wlodarczyk
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland
| | - Monika Musial-Kulik
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland
| | - Katarzyna Jelonek
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland
| | - Mateusz Stojko
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland; Department of Biopharmacy, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 8 Jednosci St., 41-200 Sosnowiec, Poland
| | - Paulina Karpeta-Jarzabek
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland
| | - Malgorzata Pastusiak
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland
| | - Henryk Janeczek
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland
| | - Piotr Dobrzynski
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland
| | - Michal Sobota
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland.
| | - Janusz Kasperczyk
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, 34 Curie-Sklodowskiej St., 41-819 Zabrze, Poland; Department of Biopharmacy, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 8 Jednosci St., 41-200 Sosnowiec, Poland
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Maria Tottoli E, Chiesa E, Ceccarelli G, Pisani S, Bruni G, Genta I, Conti B, Dorati R. BioFiber: An advanced fibrous textured dressing to manage exudate in severe wounds. Int J Pharm 2022; 625:122073. [PMID: 35931393 DOI: 10.1016/j.ijpharm.2022.122073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 10/16/2022]
Abstract
Biofiber is a new generation of highly absorbent, and textured bandage with patented fiber technology. Biofiber has a sophisticated texture that provides an optimum balance of moisture, flexibility, and conformability, and it has been developed with specific properties to treat complex injuries like burns. The dressing has been designed to be completely adaptable to human anatomy, and it can be fitted to any part of the body, adapting to all curves and jointures, as well as fitting the facial features. Prototypes of PLA-PCL-based textured bandages were developed by electrospinning, characterized, and evaluated for complex wound care. The texture is both esthetic and functional; fibers were uniformly sized (2.2 ± 0.8 and 4.5 ± 0.3 µm) and well interconnected. The texture facilitates vertical absorption of exudate up to 2.5 g/g of bandage, and the high contact angle values (120 - 100°) create an optimum balance of moisture for the healing process. The textured prototypes turned out to be extremely stable; no sign of bandage debris was found by the standard test, BS EN 13726-1.7. In addition, the round texture (3R) showed improvements in tensile strength (0.27 ± 0.019 MPa), ultimate tensile strength (0.83 ± 0.05 MPa) with higher breaking point (0.91 ± 0.05 MPa) compared to control (Mepilex Lite®). The amount of albumin (BSA) and Fibrinogen (Fb) adhered on textured fiber prototypes was calculated by BCA Assay, all prototypes demonstrated strong BSA (ranging from 81.66 ± 8.93 to 182.73 ± 2.07 μg protein/mg dressing) and enhanced Fb shielding (ranging from 108.25 ± 7.3 to 238.12 ± 17.76 μg protein/mg dressing). Their MVTR values ranged from 2313.27 ± 58.86 to 2603.33 ± 50.41 g/m2· day and vertical wicking heights were between 24.6 ± 2.5 and 29.3 ± 4.1 mm; biological tests demonstrated good compatibility of prototypes (cell vitality > 70 %), percentage of cells attachment was in-between 114 and 225 %. The extent of attachment depends on texture, differing topographical patterns presented higher attachment compared with both CTR + and 1P prototype (no texture). Cells were growth on textured fiber prototypes, and the extent of proliferation depend on incubation time.
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Affiliation(s)
| | - Enrica Chiesa
- Department of Fondazione IRCCS Policlinico San Matteo, Department of Surgery, University of Pavia, 27100, Italy
| | - Gabriele Ceccarelli
- Department of Public Health, Experimental Medicine and Forensic, University of Pavia, Pavia 27100, Italy; CHT Center for Health Technologies, University of Pavia, Pavia 27100, Italy
| | - Silvia Pisani
- Department of Otolaryngology, IRCCS Policlinico S. Matteo, Pavia 27100, Italy
| | - Giovanna Bruni
- Department of Chemistry, Physical-Chemistry Section, University of Pavia, Via Taramelli 16, Pavia 27100, Italy
| | - Ida Genta
- Department of Drug Sciences, University of Pavia, Pavia 27100, Italy; CHT Center for Health Technologies, University of Pavia, Pavia 27100, Italy
| | - Bice Conti
- Department of Drug Sciences, University of Pavia, Pavia 27100, Italy; CHT Center for Health Technologies, University of Pavia, Pavia 27100, Italy
| | - Rossella Dorati
- Department of Drug Sciences, University of Pavia, Pavia 27100, Italy.
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40
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Alabi A, Haladu N, Scott NW, Imamura M, Ahmed I, Ramsay G, Brazzelli M. Mesh fixation techniques for inguinal hernia repair: an overview of systematic reviews of randomised controlled trials. Hernia 2022; 26:973-987. [PMID: 34905142 PMCID: PMC9334446 DOI: 10.1007/s10029-021-02546-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/24/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE Inguinal hernia repair using surgical mesh is a very common surgical operation. Currently, there is no consensus on the best technique for mesh fixation. We conducted an overview of existing systematic reviews (SRs) of randomised controlled trials to compare the risk of chronic pain and recurrence following open and laparoscopic inguinal hernia repairs using various mesh fixation techniques. METHODS We searched major electronic databases in April 2020 and assessed the methodological quality of identified reviews using the AMSTAR-2 tool. RESULTS We identified 20 SRs of variable quality assessing suture, self-gripping, glue, and mechanical fixation. Across reviews, the risk of chronic pain after open mesh repair was lower with glue fixation than with suture and comparable between self-gripping and suture. Incidence of chronic pain was lower with glue fixation than with mechanical fixation in laparoscopic repairs. There were no significant differences in recurrence rates between fixation techniques in open and laparoscopic mesh repairs, although fewer recurrences were reported with suture. Many reviews reported wide confidence intervals around summary estimates. Despite no clear evidence of differences among techniques, two network meta-analyses (one assessing open repairs and one laparoscopic repairs) ranked glue fixation as the best treatment for reducing pain and suture for reducing the risk of recurrence. CONCLUSION Glue fixation may be effective in reducing the incidence of chronic pain without increasing the risk of recurrence. Future research should consider both the effectiveness and cost-effectiveness of fixation techniques alongside the type of mesh and the size and location of the hernia defect.
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Affiliation(s)
- A Alabi
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Luton and Dunstable University Hospital, Luton, UK
| | - N Haladu
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Emergency Department, Southend University Teaching Hospital, Westcliff-on-Sea, UK
| | - N W Scott
- Medical Statistics Team, University of Aberdeen, Aberdeen, UK
| | - M Imamura
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - I Ahmed
- Department of Surgery, NHS Grampian, Aberdeen, UK
| | - G Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK.,Department of Surgery, NHS Grampian, Aberdeen, UK
| | - M Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
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Casagrande G, Ibrahimi M, Semproni F, Iacovacci V, Menciassi A. Hydraulic Detrusor for Artificial Bladder Active Voiding. Soft Robot 2022; 10:269-279. [PMID: 35759369 DOI: 10.1089/soro.2021.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The gold standard treatment for bladder cancer is radical cystectomy that implies bladder removal coupled to urinary diversions. Despite the serious complications and the impossibility of controlled active voiding, bladder substitution with artificial systems is a challenge and cannot represent a real option, yet. In this article, we present hydraulic artificial detrusor prototypes to control and drive the voiding of an artificial bladder (AB). These prototypes rely on two actuator designs (origami and bellows) based either on negative or positive operating pressure, to be combined with an AB structure. Based on the bladder geometry and size, we optimized the actuators in terms of contraction/expansion performances, minimizing the liquid volume required for actuation and exploring different actuator arrangements to maximize the voiding efficiency. To operate the actuators, an ad hoc electrohydraulic circuit was developed for transferring liquid between the actuators and a reservoir, both of them intended to be implanted. The AB, actuators, and reservoir were fabricated with biocompatible flexible thermoplastic materials by a heat-sealing process. We assessed the voiding efficiency with benchtop experiments by varying the actuator type and arrangement at different simulated patient positions (horizontal, 45° tilted, and vertical) to identify the optimal configuration and actuation strategy. The most efficient solution relies on two bellows actuators anchored to the AB. This artificial detrusor design resulted in a voiding efficiency of about 99%, 99%, and 89%, in the vertical, 45° tilted, and horizontal positions, respectively. The relative voiding time was reduced by about 17, 24, and 55 s compared with the unactuated bladder.
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Affiliation(s)
- Giada Casagrande
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Michele Ibrahimi
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Federica Semproni
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Veronica Iacovacci
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.,Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Arianna Menciassi
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
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Risk of Reopening of the Mesenteric Defects After Routine Closure in Laparoscopic Roux-en-Y Gastric Bypass: a Single-Centre Experience. Obes Surg 2022; 32:2853-2859. [PMID: 35760981 DOI: 10.1007/s11695-022-06179-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/18/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Small bowel obstruction (SBO) due to internal hernias (IH) is a well-recognised complication after laparoscopic Roux-en-Y gastric bypass (LRYGB). Routine closure of the mesenteric defects (MDs) is recommended to reduce the risk of IH and subsequent SBO. However, data about the rates of reopening of the MDs after LRYGB is scarce. The main aim of this study was to evaluate the risk of reopening of the MDs after routine closure during LRYGB. The secondary objective was to determine any risk factors associated with the reopening of the MDs. METHODS Data of all patients who underwent reoperations after LRYGB with closure of both MDs between January 2010 and December 2018 were retrospectively reviewed. RESULTS A total of 162 patients were included. The median time between LRYGB and reoperation was 17 months. At the time of reoperation, both MDs were closed in 83 patients (51.2%); thus, 79 patients (48.8%) presented at least one open MD. The group of patients with preoperative diagnosis of SBO or with recurrent abdominal pain showed significantly higher rates of open Petersen's space compared to the group of patients with other preoperative diagnoses. Preoperative body mass index (BMI) less than 40 kg/m2 at time of LRYGB was associated with a higher risk for an open MD. CONCLUSION At least one MD reopened in almost half of the patients despite routine closure during LRYGB. Therefore, the status of MDs should be routinely examined during every reoperation after LRYGB and closure of open MDs should be performed.
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Utrabo CAL, Busato CR, Montemór-Netto MR, Lipinski LC, Celinski VR, Ferronato MF, Malafaia O, Koga AY. THE USE OF SURGICAL ADHESIVE AND SUTURE FIXING MESHES TO THE ABDOMINAL WALL: AN EXPERIMENTAL STUDY IN RATS. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2022; 35:e1649. [PMID: 35730878 PMCID: PMC9254444 DOI: 10.1590/0102-672020210002e1649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/02/2022] [Indexed: 06/15/2023]
Abstract
AIM Proper fixation of the surgical mesh determines the success of a herniorrhaphy. Understanding the inflammatory response and the mechanical properties of the mesh helps to define whether a fixation method is superior. This study aimed to evaluate the healing of defects in the abdominal wall of rats, comparing the repair of macroporous polypropylene meshes fixed with surgical glue and polypropylene thread. METHODS In 20 Wistar rats, a defect was produced in the abdominal wall, with the integrity of the parietal peritoneum. For correction, the meshes were fixed with surgical glue (2-octyl cyanoacrylate) (subgroup C1), or polypropylene suture (subgroup C2). The two subgroups of 10 animals were euthanized on the 90th postoperative day, and the fragments of the abdominal wall were submitted to macroscopic, histological, and tensiometric analysis. RESULTS Macroscopic analysis did not show any abnormalities. Tensiometry on the 90th postoperative day in subgroup C1 showed mean rupture tension of 28.47N and in subgroup C2 32.06N (p=0.773). The inflammatory process score revealed that both groups are in the subacute phase (p=0.380). CONCLUSION The fixation of a polypropylene macroporous mesh to repair an abdominal wall defect can be performed with surgical glue (2-octyl cyanoacrylate) or polypropylene suture, both methods being equally effective.
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Affiliation(s)
| | | | | | | | | | | | - Osvaldo Malafaia
- Evangelical Mackenzie Faculty of Paraná, Curitiba, PR, Brazil
- Federal University of Paraná, Curitiba, PR, Brazil
| | - Adriana Yuriko Koga
- School of Medicine, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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Helmedag MJ, Heise D, Eickhoff RM, Schmitz SM, Mechelinck M, Emonts C, Bolle T, Gries T, Neumann UP, Klink CD, Lambertz A. Ultra-Fine Polyethylene Hernia Meshes Improve Biocompatibility and Reduce Intraperitoneal Adhesions in IPOM Position in Animal Models. Biomedicines 2022; 10:biomedicines10061294. [PMID: 35740316 PMCID: PMC9220266 DOI: 10.3390/biomedicines10061294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/15/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Introduction: The intraperitoneal onlay mesh technique (IPOM) is widely used to repair incisional hernias. This method has advantages but suffers from complications due to intraperitoneal adhesion formation between the mesh and intestine. An ideal mesh minimizes adhesions and shows good biocompatibility. To address this, newly developed multifilamentous polyethylene (PET) meshes were constructed from sub-macrophage-sized monofilaments and studied regarding biocompatibility and adhesion formation. (2) Methods: We investigated fine (FPET, 72 filaments, 11 µm diameter each) and ultra-fine multifilament (UFPET, 700 filaments, 3 µm diameter each) polyethylene meshes for biocompatibility in subcutaneous implantation in rats. Adhesion formation was analyzed in the IPOM position in rabbits. Geometrically identical mono-filamentous polypropylene (PP) Bard Soft® PP meshes were used for comparison. Histologic and immune-histologic foreign body reactions were assessed in 48 rats after 7 or 21 days (four mesh types, with two different mesh types per rat; n = 6 per mesh type). Additionally, two different mesh types each were placed in the IPOM position in 24 rabbits to compile the Diamond peritoneal adhesion score after the same timeframes. The biocompatibility and adhesion score differences were analyzed with the Kruskal–Wallis nonparametric statistical test. (3) Results: Overall, FPET and, especially, UFPET showed significantly smaller foreign body granulomas compared to PP meshes. Longer observation periods enhanced the differences. Immunohistology showed no significant differences in the cellular immune response and proliferation. UFPET demonstrated significantly reduced peritoneal adhesion formation compared to all other tested meshes after 21 days. (4) Conclusions: Overall, FPET and, especially, UFPET demonstrated their suitability for IPOM hernia meshes in animal models by improving major aspects of the foreign body reaction and reducing adhesion formation.
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Affiliation(s)
- Marius J. Helmedag
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (D.H.); (R.M.E.); (S.M.S.); (U.P.N.); (C.D.K.); (A.L.)
- Correspondence:
| | - Daniel Heise
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (D.H.); (R.M.E.); (S.M.S.); (U.P.N.); (C.D.K.); (A.L.)
| | - Roman M. Eickhoff
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (D.H.); (R.M.E.); (S.M.S.); (U.P.N.); (C.D.K.); (A.L.)
| | - Sophia M. Schmitz
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (D.H.); (R.M.E.); (S.M.S.); (U.P.N.); (C.D.K.); (A.L.)
| | - Mare Mechelinck
- Department of Anesthesiology, Uniklinik RWTH Aachen, 52074 Aachen, Germany;
| | - Caroline Emonts
- Institut für Textiltechnik, RWTH Aachen University, 52074 Aachen, Germany; (C.E.); (T.B.); (T.G.)
| | - Tim Bolle
- Institut für Textiltechnik, RWTH Aachen University, 52074 Aachen, Germany; (C.E.); (T.B.); (T.G.)
| | - Thomas Gries
- Institut für Textiltechnik, RWTH Aachen University, 52074 Aachen, Germany; (C.E.); (T.B.); (T.G.)
| | - Ulf Peter Neumann
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (D.H.); (R.M.E.); (S.M.S.); (U.P.N.); (C.D.K.); (A.L.)
| | - Christian Daniel Klink
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (D.H.); (R.M.E.); (S.M.S.); (U.P.N.); (C.D.K.); (A.L.)
| | - Andreas Lambertz
- Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (D.H.); (R.M.E.); (S.M.S.); (U.P.N.); (C.D.K.); (A.L.)
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Lequeux A, Maze B, Laroche G, Heim F. Non-woven textiles for medical implants: mechanical performances improvement. BIOMED ENG-BIOMED TE 2022; 67:317-330. [PMID: 35611716 DOI: 10.1515/bmt-2022-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/03/2022] [Indexed: 11/15/2022]
Abstract
Non-woven textile has been largely used as medical implant material over the last decades, especially for scaffold manufacturing purpose. This material presents a large surface area-to-volume ratio, which promotes adequate interaction with biological tissues. However, its strength is limited due to the lack of cohesion between the fibers. The goal of the present work was to investigate if a non-woven substrate can be reinforced by embroidery stitching towards strength increase. Non-woven samples were produced from both melt-blowing and electro-spinning techniques, reinforced with a stitching yarn and tested regarding several performances: ultimate tensile strength, burst strength and strength loss after fatigue stress. Several stitching parameters were considered: distance between stitches, number of stitch lines (1, 2 or 3) and line geometry (horizontal H, vertical L, cross X). The performance values obtained after reinforcement were compared with values obtained for control samples. Results bring out that reinforcement can increase the strength by up to 50% for a melt-blown mat and by up to 100% for an electro-spun mat with an X reinforcement pattern. However, after cyclic loading, the reinforcement yarn tends to degrade the ES mat in particular. Moreover, increasing the number of stitches tends to fragilize the mats.
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Affiliation(s)
- Amandine Lequeux
- Laboratoire de Physique et Mécanique Textiles (LPMT), ENSISA, Mulhouse, France
| | - Benoit Maze
- The Nonwovens Institute, North Carolina State University, Raleigh, NC, USA
| | - Gaetan Laroche
- Département de Génie des Mines, de la Métallurgie et des Matériaux, Laboratoire d'Ingénierie de Surface, Centre de Recherche sur les Matériaux Avancés, Université Laval, Québec, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Québec, Hôpital St-François d'Assise, Québec, Canada
| | - Frederic Heim
- Laboratoire de Physique et Mécanique Textiles (LPMT), ENSISA, Mulhouse, France
- Geprovas, Strasbourg, France
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46
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Radiological Characterization of Synthetic Mesh in Female Urological Procedures: a Review of the Literature. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-022-00652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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47
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A review of recent developments of polypropylene surgical mesh for hernia repair. OPENNANO 2022. [DOI: 10.1016/j.onano.2022.100046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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48
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Ajdary R, Abidnejad R, Lehtonen J, Kuula J, Raussi-Lehto E, Kankuri E, Tardy B, Rojas OJ. Bacterial nanocellulose enables auxetic supporting implants. Carbohydr Polym 2022; 284:119198. [DOI: 10.1016/j.carbpol.2022.119198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 01/08/2023]
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49
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Hu Q, Wu J, Zhang H, Dong W, Gu Y, Liu S. Designing Double-Layer Multi-Material Composite Patch Scaffold with Adhesion Resistance for Hernia Repair. Macromol Biosci 2022; 22:e2100510. [PMID: 35471592 DOI: 10.1002/mabi.202100510] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/12/2022] [Indexed: 11/10/2022]
Abstract
Hernia repair mesh is associated with a number of complications, including adhesions and limited mobility, due to insufficient mechanical strength and non-resorbability. Among them, visceral adhesions are one of the most serious complications of patch repair. In this study, a degradable patch with an anti-adhesive layer was prepared for hernia repair by 3D printing and electrospinning techniques using polycaprolactone (PCL), polyvinyl alcohol (PVA), and soybean peptide (SP). The study into the physicochemical properties of the patch was found that it had adequate mechanical strength requirements (16 N cm-1 ) and large elongation at break, which were superior than commercial polypropylene (PP) patches. In vivo and in vitro experiments showed that human umbilical vein endothelial cells (HUVECs) proliferated well on composite patches, and showed excellent biocompatibility with the host and little adhesion through a rat abdominal wall defect model. In conclusion, the results of this study show that composite patch can effectively reduce the occurrence of adhesions, while the addition of SP in the patch further enhances its biocompatibility. We believe that a regenerative biological patch with great potential in hernia repair provides a new strategy for the development of new biomimetic biodegradable patches. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Qingxi Hu
- Rapid Manufacturing Engineering Center, School of Mechatronical Engineering and Automation, Shanghai University, Shanghai, 200444, China.,Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, 200072, China.,National Demonstration Center for Experimental Engineering Training Education, Shanghai University, Shanghai, 200444, China
| | - Junjie Wu
- Rapid Manufacturing Engineering Center, School of Mechatronical Engineering and Automation, Shanghai University, Shanghai, 200444, China
| | - Haiguang Zhang
- Rapid Manufacturing Engineering Center, School of Mechatronical Engineering and Automation, Shanghai University, Shanghai, 200444, China.,Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, 200072, China.,National Demonstration Center for Experimental Engineering Training Education, Shanghai University, Shanghai, 200444, China
| | - Wenpei Dong
- Department of General Surgery, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Yan Gu
- Department of General Surgery, Huadong Hospital, Fudan University, Shanghai, 200040, China
| | - Suihong Liu
- Rapid Manufacturing Engineering Center, School of Mechatronical Engineering and Automation, Shanghai University, Shanghai, 200444, China
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50
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Franklyn J, Ramesh S, Madhuri V, Patel B, Dhivya A, Nair PD, Kumar A, Chacko G, Samarasam I. Abdominal Wall Reconstruction with Tissue-Engineered Mesh Using Muscle-Derived Stem Cells in an Animal Model. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2022. [DOI: 10.1007/s40883-022-00253-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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