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Karmakar D, Basu KS, Basu S, Chakrabarty S, Saha K, Ghosh D. Acellular Bovine Pericardial Patch for Difficult Abdominal Closure in the Pediatric Population: Our Experience with Review of Literature. J Indian Assoc Pediatr Surg 2024; 29:233-239. [PMID: 38912025 PMCID: PMC11192272 DOI: 10.4103/jiaps.jiaps_230_23] [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: 11/03/2023] [Revised: 11/19/2023] [Accepted: 01/16/2024] [Indexed: 06/25/2024] Open
Abstract
Aims Closure of congenital body wall defects in children can be a challenging task for the pediatric Surgeon. Biological prosthesis has been increasingly used for high-risk wound closure in adult patients with excellent outcomes and use in the pediatric population has also been reported. Here, we aim to study the outcome of abdominal wound repair with a tissue-engineered acellular bovine pericardial patch. Methods Over a period of 21 months, a total of 15 children had undergone abdominal wound repair with bioprostheses, i.e., bovine pericardial patch at our institute. Patient demographics, cause of defect, an indication of patch use, rate of infection, postoperative recovery, recurrence, and outcome were studied. Results A total of 15 patients underwent abdominal wall closure with acellular bovine pericardial patch. Nine out of 15 patients were neonates, of whom five had gastroschisis, two had a congenital diaphragmatic hernia, and two had ruptured omphalocele major. Of the rest 6 patients, 2 were patients of bladder exstrophy, 2 were older children of congenital diaphragmatic hernia with incisional hernias, and 2 were older children with omphalocele major. Out of the five patients with gastroschisis, two died during the early postoperative period due to sepsis. The wound healed in the rest 13 patients with mild skin dehiscence in two patients. Only one child had a recurrence. Conclusion Reconstruction with acellular bovine pericardial patch is a viable option in children with high-risk abdominal wounds as it allows tensionless repair with excellent healing and minimal complications. Recurrence, if any, may disappear with time as remodeling of the prosthesis occurs along with the growth of the body wall of the child.
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Affiliation(s)
- Debalina Karmakar
- Department of Paediatric Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Kalyani Saha Basu
- Department of Paediatric Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Syamantak Basu
- Department of Paediatric Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Saikat Chakrabarty
- Department of Paediatric Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Koushik Saha
- Department of Paediatric Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
| | - Dipak Ghosh
- Department of Paediatric Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
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Hisano M, Matsuura T, Koizumi J, Ito A, Kato R, Maekawa S, Kanehira M, Sugimura J, Kin H, Obara W. A case of severe ureteral injury repaired by renal autotransplantation with an iliac vein patch using bovine pericardium. IJU Case Rep 2024; 7:157-160. [PMID: 38440711 PMCID: PMC10909134 DOI: 10.1002/iju5.12691] [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: 09/22/2023] [Accepted: 01/05/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction Renal autotransplantation is considered a surgical procedure for extensive ureteral defects. Herein, we report a case of severe ureteral injury repaired by laparoscopic nephrectomy and renal autotransplantation with an iliac vein patch using bovine pericardium. Case presentation A 56-year-old woman who had previously undergone gynecological surgery complained of right-sided abdominal pain. She was then later diagnosed with a right middle ureteral injury with a 5-cm long defect. We performed retroperitoneal laparoscopic nephrectomy and renal autotransplantation. As the iliac vein was fragile, venous patching using bovine pericardium was performed. The patient's renal function was well preserved after surgery. Conclusion Laparoscopic nephrectomy and renal autotransplantation is an effective method for repairing severe ureteral injury with the preservation of renal function. A venous patch using bovine pericardium might be considered as a replacement for a fragile vein.
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Affiliation(s)
- Mizuki Hisano
- Department of UrologyIwate Medical University School of MedicineYahabaJapan
| | - Tomohiko Matsuura
- Department of UrologyIwate Medical University School of MedicineYahabaJapan
| | - Junichi Koizumi
- Department of Cardiovascular SurgeryIwate Medical University School of MedicineYahabaJapan
| | - Akito Ito
- Division of UrologyIwate Prefectural Chubu HospitalKitakamiJapan
| | - Renpei Kato
- Department of UrologyIwate Medical University School of MedicineYahabaJapan
| | - Shigekatsu Maekawa
- Department of UrologyIwate Medical University School of MedicineYahabaJapan
| | - Mitsugu Kanehira
- Department of UrologyIwate Medical University School of MedicineYahabaJapan
| | - Jun Sugimura
- Department of UrologyIwate Medical University School of MedicineYahabaJapan
| | - Hajime Kin
- Department of Cardiovascular SurgeryIwate Medical University School of MedicineYahabaJapan
| | - Wataru Obara
- Department of UrologyIwate Medical University School of MedicineYahabaJapan
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Otieno DO, Malik J, Wabwire B. Pediatric patient with a complex Abdominal Wall defect reconstructed with sandwich omental flap. A case report. Int J Surg Case Rep 2023; 109:108512. [PMID: 37478702 PMCID: PMC10375844 DOI: 10.1016/j.ijscr.2023.108512] [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: 05/17/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Low grade Fibromyxoid sarcoma (LGFMS) is a rare soft tissue sarcoma. LGFMS has an indolent clinical behavior but it is prone for late local recurrence and metastasis. In children it is commonly seen in the subcutaneous tissues relative to adults where it presents in deep soft tissues. These patients are best managed in a specialized unit with a multidisciplinary team. For patients with sarcoma, wide local excision remains the treatment of choice. Large complex abdominal wall defects present a unique reconstructive challenge to the surgeon following tumor removal. CASE PRESENTATION Here, we present a case of a 9-year old pediatric male patient with complex abdominal wall defect post excision of a recurrent fibromyxoid sarcoma, reconstructed with a sandwich omental flap, monofilament polypropylene mesh (Bard® Mesh) and split-thickness skin graft (STSG). CLINICAL DISCUSSION Despite the success of covering the defect, the patient still had quite a bit of morbidity with the following:abdominal hernia defect and tumor recurrence. Our case demonstrates the diagnostic and therapeutic challenges in management of sarcomas hence the need for these patients to be managed through a multidisciplinary approach. CONCLUSION The omental flap is quite versatile, and knowing how to raise it does not require sophisticated microsurgical skills. It adds to the reconstructive surgeon's armamentarium, especially in resource-limited settings.
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Affiliation(s)
- Daniel Odhiambo Otieno
- Department of Plastic, Reconstructive and Aesthetic Surgery University of Nairobi School of Medicine, Nairobi, Kenya.
| | - Janan Malik
- Department of Plastic, Reconstructive and Aesthetic Surgery University of Nairobi School of Medicine, Nairobi, Kenya
| | - Benjamin Wabwire
- Department of Plastic, Reconstructive and Aesthetic Surgery Kenyatta National Hospital, Nairobi, Kenya
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Saiding Q, Chen Y, Wang J, Pereira CL, Sarmento B, Cui W, Chen X. Abdominal wall hernia repair: from prosthetic meshes to smart materials. Mater Today Bio 2023; 21:100691. [PMID: 37455815 PMCID: PMC10339210 DOI: 10.1016/j.mtbio.2023.100691] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/15/2023] [Accepted: 06/03/2023] [Indexed: 07/18/2023] Open
Abstract
Hernia reconstruction is one of the most frequently practiced surgical procedures worldwide. Plastic surgery plays a pivotal role in reestablishing desired abdominal wall structure and function without the drawbacks traditionally associated with general surgery as excessive tension, postoperative pain, poor repair outcomes, and frequent recurrence. Surgical meshes have been the preferential choice for abdominal wall hernia repair to achieve the physical integrity and equivalent components of musculofascial layers. Despite the relevant progress in recent years, there are still unsolved challenges in surgical mesh design and complication settlement. This review provides a systemic summary of the hernia surgical mesh development deeply related to abdominal wall hernia pathology and classification. Commercial meshes, the first-generation prosthetic materials, and the most commonly used repair materials in the clinic are described in detail, addressing constrain side effects and rational strategies to establish characteristics of ideal hernia repair meshes. The engineered prosthetics are defined as a transit to the biomimetic smart hernia repair scaffolds with specific advantages and disadvantages, including hydrogel scaffolds, electrospinning membranes, and three-dimensional patches. Lastly, this review critically outlines the future research direction for successful hernia repair solutions by combing state-of-the-art techniques and materials.
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Affiliation(s)
- Qimanguli Saiding
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, 910 Hengshan Road, Shanghai, 200030, PR China
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, PR China
| | - Yiyao Chen
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, 910 Hengshan Road, Shanghai, 200030, PR China
| | - Juan Wang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, PR China
| | - Catarina Leite Pereira
- I3S – Instituto de Investigação e Inovação Em Saúde and INEB – Instituto de Engenharia Biomédica, Universidade Do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal
| | - Bruno Sarmento
- I3S – Instituto de Investigação e Inovação Em Saúde and INEB – Instituto de Engenharia Biomédica, Universidade Do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal
- IUCS – Instituto Universitário de Ciências da Saúde, CESPU, Rua Central de Gandra 1317, 4585-116, Gandra, Portugal
| | - Wenguo Cui
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, PR China
| | - Xinliang Chen
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, 910 Hengshan Road, Shanghai, 200030, PR China
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Decellularization and In Vivo Recellularization of Abdominal Porcine Fascial Tissue. Tissue Eng Regen Med 2020; 18:369-376. [PMID: 33230802 DOI: 10.1007/s13770-020-00314-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/11/2020] [Accepted: 10/19/2020] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Tissue decellularization has evolved as a promising approach for tissue engineering applications. METHODS In this study, we harvested fascial tissue from porcine anterior abdominal wall and the samples were decellularized with a combination of agents such as Triton X-100, trypsin and DNAase. Afterwards, we evaluated cell removal by histological analysis and DNA quantification. Mechanical functionality was evaluated by applying a range of hydrostatic pressures. A sample of decellularized fascia was transplanted into a rabbit and after 15 days a biopsy of this tissue was examined; the animal was observed during 6 months after surgery. RESULTS The extracellular matrix was retained with a complete decellularization as evidenced by histologic examination. The DNA content was significantly reduced. The scaffold preserved its tensile mechanical properties. The graft was incorporated into a full thickness defect made in the rabbit abdominal wall. This tissue was infiltrated by granulation and inflammatory cells and the histologic structure was preserved 15 days after surgery. The animal did not develop hernias, infections or other complications, after a 6-months of follow up. CONCLUSIONS The protocol of decellularization of fascial tissue employed in this study proved to be efficient. The mechanical test demonstrated that the samples were not damaged and maintained its physical characteristics; clinical evolution of the rabbit, recipient of the decellularized fascia, demonstrated that the graft was effective as a replacement of native tissue.In conclusion, a biological scaffold derived from porcine fascial tissue may be a suitable candidate for tissue engineering applications.
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Zhao L, Jia Y, Zhao C, Li H, Wang F, Dong M, Liu T, Zhang S, Zhou Q, Shi W. Ocular surface repair using decellularized porcine conjunctiva. Acta Biomater 2020; 101:344-356. [PMID: 31706041 DOI: 10.1016/j.actbio.2019.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/28/2019] [Accepted: 11/04/2019] [Indexed: 11/19/2022]
Abstract
The primary functions of the conjunctiva embody ocular surface protection and the maintenance of the tear film equilibrium. Severe conjunctival defects such as symblepharon may impair the integrity of ocular surface and cause loss of visual functions. Here we report the use of a decellularized porcine conjunctiva (DPC) for conjunctival reconstruction in rabbit models and in clinic. Our results show that the major xenoantigens are efficiently removed, while abundant matrix components and integrated microstructures are well preserved in the DPC. These characteristics provide mechanical support and favorable histocompatibility for repairing damaged conjunctiva. The DPC application has demonstrated enhanced transplant stability and improved epithelial regeneration in severe ocular surface damage comparing to those of amniotic membrane (AM), the most frequently applied matrix for ocular surface reconstruction nowadays. In order to test the DPC performance in clinic, three patients with pterygium and one patient with symblepharon underwent transplant with DPC. The grafts in all cases were completely re-epithelized and no graft melt or fibroplasia were observed. These results suggest that the strategy we developed is feasible and effective for conjunctival reconstruction and ocular surface repair. STATEMENT OF SIGNIFICANCE: In this study, we adopted an innovative approach to prepare decellularized porcine conjunctiva (DPC). The intricate conjunctiva-specific structures and abundant matrix components were preserved in DPC, which offers favorable mechanical properties for graft. DPC has shown positive effects in ocular surface repair, which has been proven particularly in a rabbit model with severe symblepharon. Reconstructed conjunctiva by DPC exhibited epithelial heterogeneity, extremely resembling that of native conjunctiva. In addition, results from clinical studies were encouraging for pterygium and symblepharon and clinical application of DPC is promising.
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Affiliation(s)
- Long Zhao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266000, China
| | - Yanni Jia
- Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Can Zhao
- Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Hua Li
- Department of Ophthalmology, Qilu Medical College of Shandong University, Jinan 250000, China
| | - Fuyan Wang
- Department of Ophthalmology, Qilu Medical College of Shandong University, Jinan 250000, China
| | - Muchen Dong
- Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Ting Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266000, China; Qingdao Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266000, China
| | - Songmei Zhang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266000, China
| | - Qingjun Zhou
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266000, China.
| | - Weiyun Shi
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266000, China; Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China.
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Abstract
BACKGROUND Cesarean scar dehiscence is rare in pregnancy. When it occurs late in pregnancy, management typically involves delivery of the fetus with concurrent uterine repair. However, consensus regarding management earlier in gestation is lacking. CASE A 30-year-old African American woman, gravida 5 para 2113, presented with cesarean scar dehiscence confirmed by magnetic resonance imaging at 20 weeks of gestation. She desired pregnancy continuation and underwent repair of the dehiscence at 23 weeks of gestation using bovine pericardial graft. She subsequently underwent cesarean delivery at 35 weeks of a healthy neonate after going into preterm labor. CONCLUSION Bovine pericardial graft is a viable option for repair of cesarean scar dehiscence in the second trimester.
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Dong M, Zhao L, Wang F, Hu X, Li H, Liu T, Zhou Q, Shi W. Rapid porcine corneal decellularization through the use of sodium N-lauroyl glutamate and supernuclease. J Tissue Eng 2019; 10:2041731419875876. [PMID: 31588337 PMCID: PMC6740050 DOI: 10.1177/2041731419875876] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/23/2019] [Indexed: 12/17/2022] Open
Abstract
Corneal decellularization represents a promising alternative source of human donor with global shortage. Multiple methods have been developed for the preparation of decellularized porcine corneal stroma. However, most strategies relied on long-time treatment to facilitate the entry of detergents or nucleases, which may cause irreversible ultrastructural damage. Here, we developed a rapid decellularization method for porcine corneal stroma through the combined mild detergent sodium N-lauroyl glutamate (SLG) and supernuclease. Compared with traditional methods, the novel decellularization method allowed the efficient removal of xenoantigen DNA within 3 h, while retaining the ultrastructure, transparency, and mechanical properties of porcine corneas. When transplanted in rabbit model for 1 month, the decellularized porcine corneal grafts presented favorable transparency and biocompatibility without immune rejection. Therefore, the combined use of detergent SLG and supernuclease may serve as a promising method for the clinical use of decellularized porcine cornea.
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Affiliation(s)
- Muchen Dong
- Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Long Zhao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Fuyan Wang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Xiaoli Hu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Hua Li
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Ting Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Qingjun Zhou
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Weiyun Shi
- Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
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Nguyen MTN, Tran HLB. Effect of Modified Bovine Pericardium on Human Gingival Fibroblasts in vitro. Cells Tissues Organs 2019; 206:296-307. [PMID: 31357195 DOI: 10.1159/000501807] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/28/2019] [Indexed: 12/17/2022] Open
Abstract
Supportive membranes have recently been applied to treat periodontal disease in order to achieve periodontal tissue regeneration. The crucial role of these membranes is to facilitate the restoration of the structural and functional periodontium. Bovine pericardium (BP) is mainly composed of collagen type I, which was demonstrated to have good mechanical properties and biological regenerative potential. Our research aimed to extend the application of membrane derived from BP to periodontal disease treatment. However, the fabrication method to achieve a xenogenic-free membrane with the mechanical properties required for periodontal treatment is rarely mentioned. Therefore, a procedure for the extraction and modification of BP using sodium dodecyl sulfate (SDS) and glutaraldehyde (GA) was developed. BP was harvested and decellularized using different SDS concentrations (0.05-0.3%). GA was used to further modify the membranes to achieve suitable thickness, mechanical strength, and pore size. A combination protocol of 0.15% SDS treatment for 12 h with continuous agitation combined with 0.1% GA for 6 h for membrane fabricating was applied. The modified BP (mBP) had the targeted characteristics, such as 0.2-0.5 mm thickness, approximately 10 MPa in tensile strength, 30% in strain force, and a pore size <5 µm, which is comparable to commercially available collagen membranes. Findings from this study demonstrated that the established method was effective in preparing BP membrane for periodontal treatment while decreasing the concentration of reagents and processing time. Moreover, our modified membrane was found to have no cytotoxicity but supports the migration, attachment, and proliferation of human gingival fibroblasts in vitro. Taken together, these results confirmed that mBP is suitable for application in periodontal disease treatment and regeneration.
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Affiliation(s)
- My Thi Ngoc Nguyen
- Laboratory of Tissue Engineering and Biomedical Materials, Department of Physiology and Animal Biotechnology, University of Science, Vietnam National University, Ho Chi Minh, Vietnam
| | - Ha Le Bao Tran
- Laboratory of Tissue Engineering and Biomedical Materials, Department of Physiology and Animal Biotechnology, University of Science, Vietnam National University, Ho Chi Minh, Vietnam,
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Al-Qaoud T, Bath N, Redfield R, Sollinger HW. Salvage Renal Autotransplant Following Previous Renal Vein Stenting in Nutcracker Syndrome. EXP CLIN TRANSPLANT 2019; 18:300-305. [PMID: 31104623 DOI: 10.6002/ect.2019.0015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Nutcracker syndrome is rare, and a proportion of patients with this syndrome continue to have intractable pain and symptoms. Due to the heterogeneity of patients' chief complaints and symptoms, the surgeon's preferred approach may be inherently different but is of paramount importance to the outcome. MATERIALS AND METHODS We present 4 cases in which renal autotransplant with extraction and ligation of previously placed gonadal coils was performed following previously attempted renal vein stenting or combined renal vein transposition followed by renal vein stenting. RESULTS Autotransplant resulted in flank pain resolution with improvement in symptoms associated with pelvic congestion syndrome. CONCLUSIONS The approach to such cases requires meticulous and adequate vena cava exposure, with preparation for potential caval reconstruction. No firm inferences can be made from such a small series; however, we believe in renal autotransplant as first-line therapy, and failure after an initial renal vein stent should be salvaged by renal autotransplant over further endovascular attempts.
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Affiliation(s)
- Talal Al-Qaoud
- From the Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, Wisconsin, USA
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11
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Gudemac E, Babuci S, Tica C, Petrovici V, Nacu V, Ionescu C, Negru I. Comparative Cellular Local Response in Abdominal Defect Plastic Surgery with Bovine Pericardium and Bovine Fascia Preserved in Formaldehyde in Experimental Rabbits. ARS MEDICA TOMITANA 2017. [DOI: 10.1515/arsm-2017-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
In the present paper, we refer to a method of primary closure of congenital defects of the anterior abdominal wall with tensionless viscero-abdominal disproportion. The study group included 10 animals subjected to surgery of the abdominal wall defect closure with bovine pericardium graft preserved in 0.5% formaldehyde, and 5 rabbits of the same breed and weight, in which bovine fascia graft was used as implant, being preserved in 0.5% formaldehyde. The abdominal anterior wall defect was made surgically by excision of the musculo-fascial structures and peritoneum. Bovine pericardium graft and bovine fascia graft were placed and fixed posteriorly to rectus abdominals muscles, having direct contact with the intra-abdominal contents and protected by suturing skin and subcutaneous layer.
The purpose of the study was to perform a comparative postoperative evaluation of local macroscopic and microscopic changes that develop after reconstruction of the major abdominal wall defects experimentally induced in rabbits, using bovine pericardium and bovine fascia grafts preserved in 0.5% formaldehyde.
In cases of major fascial defects of the anterior abdominal wall, bovine pericardium graft has acceptable strength and biocompatibility, having stabilizing properties of the abdominal wall due to the development of the connective tissue layer located between the implant and the subcutaneous layer. Bovine fascia grafts preserved in formaldehyde have an insignificant irritating and inflammatory action on the intestinal loops compared with bovine pericardium, and do not induce the development of a significant abdominal adhesion process, this allowing their use in the abdominal fascial defects closure with placement in direct contact with the abdominal contents.
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Affiliation(s)
- Eva Gudemac
- State University of Medicine and Pharmacy “Nicolae Testemițanu”, Chisinau , Republic of Moldova
| | - S. Babuci
- State University of Medicine and Pharmacy “Nicolae Testemițanu”, Chisinau , Republic of Moldova
| | - C. Tica
- University “Ovidius” of Constanta, Faculty of Medicine, Constanta , Romania
| | - V. Petrovici
- State University of Medicine and Pharmacy “Nicolae Testemițanu”, Chisinau , Republic of Moldova
| | - V. Nacu
- State University of Medicine and Pharmacy “Nicolae Testemițanu”, Chisinau , Republic of Moldova
| | - C. Ionescu
- Faculty of Medicine, Univeristy „Ovidius” of Constanta Universitatii Alee No. 1, Campus B, Constanta , Romania
| | - I. Negru
- State University of Medicine and Pharmacy “Nicolae Testemițanu”, Chisinau , Republic of Moldova
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The Use of Tutomesh for a Tension-Free and Tridimensional Repair of Uterovaginal and Vaginal Vault Prolapse: Preliminary Report. Surg Res Pract 2015; 2015:303679. [PMID: 26425731 PMCID: PMC4575740 DOI: 10.1155/2015/303679] [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: 01/22/2015] [Revised: 07/03/2015] [Accepted: 08/02/2015] [Indexed: 11/17/2022] Open
Abstract
Objective. To evaluate efficacy in terms of vaginal capacity, coital function, and recurrence prevention of a new biological mesh of bovine pericardium (Tutomesh) in the repair of severe POP. Methods. Thirty cases of patients suffering from stage III uterine or apical prolapse undergone surgical repair by means of a modified sacrospinous ligament suspension combined with mesh attachment to both the cardinal ligaments, posterior and anterior colporrhaphy, and perineal body fixation. The mesh was replaced inside the pelvis with the goal of reconstructing the tridimensional fascial disposition of the structures sustaining the correct axis of vagina. Follow-up was done at 12 months with POPIQ analysis. Results. One total mesh failure occurred early after surgery due to marked deficiency of anatomy. Two cystoceles were observed at 12 months in two patients treated for apical prolapse where anterior repair was not performed. Two other patients developed a de novo SUI at 12 months. No reported abnormalities of coital function or dyspareunia were ever found after surgery. Conclusions. It is possible that the utilization of a tension-free and tridimensional placement of Tutomesh might favor a more physiologic reconstruction of the vaginal axis as compared with traditional sacrospinous ligament suspension.
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Wu Q, Dai M, Xu P, Hou M, Teng Y, Feng J. In vivo effects of human adipose-derived stem cells reseeding on acellular bovine pericardium in nude mice. Exp Biol Med (Maywood) 2015; 241:31-9. [PMID: 26253192 DOI: 10.1177/1535370215597193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 06/16/2015] [Indexed: 01/23/2023] Open
Abstract
Tissue-engineered biologic products may be a viable option in the reconstruction of pelvic organ prolapse (POP). This study was based on the hypothesis that human adipose-derived stem cells (hASCs) are viable in acellular bovine pericardium (ABP), when reseeded by two different techniques, and thus, aid in the reconstruction. To investigate the reseeding of hASCs on ABP grafts by using non-invasive bioluminescence imaging (BLI), and to identify the effective hASCs-scaffold combinations that enabled regeneration. Thirty female athymic nude mice were randomly divided into three groups: In the VIVO group, ABPs were implanted in the subcutaneous pockets and enhanced green fluorescent protein luciferase (eGFP·Luc)-hASCs (1 × 10(6) cells/50 µL) were injected on the ABP at the same time. In the VITRO group, the mice were implanted with grafts that ABP were co-cultured with eGFP·Luc-hASCs in vitro. The BLANK group mice were implanted with ABP only. The eGFP·Luc-hASCs reseeded on ABP were analyzed by BLI, histology, and immunohistochemistry. The eGFP·Luc-hASCs reseeded on ABP could be visualized at 12 weeks in vivo. Histology revealed that the VIVO group displayed the highest cell ingrowths, small vessels, and percent of collagen content per unit area. Desmin and α-smooth muscle actin were positive at the same site in the VIVO group cells. However, few smooth muscles were observed in the VITRO and BLANK groups. These results suggest that hASCs reseeded on ABP in vivo during surgery may further enhance the properties of ABP and may promote regeneration at the recipient site, resulting in a promising treatment option for POP.
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Affiliation(s)
- Qingkai Wu
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Miao Dai
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Peirong Xu
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Min Hou
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yincheng Teng
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Jie Feng
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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Hunter JD, Cannon JA. Biomaterials: so many choices, so little time. What are the differences? Clin Colon Rectal Surg 2014; 27:134-9. [PMID: 25435822 DOI: 10.1055/s-0034-1394087] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The use of biologic mesh has increased greatly in recent years in response to the need for a solution in managing contaminated hernias. Multiple different meshes are commercially available, and are derived from a variety of sources, including human dermis as well as animal sources. For a mesh to be effective, it must be resistant to infection, have adequate tensile strength for hernia repair, and be well tolerated by the host. To achieve this end, biologic meshes go through an intense processing that varies from one product to the next. In this article, the authors review the types of mesh available, how they are processed, and examine these characteristics in terms of their strengths and weaknesses in application to surgical technique.
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Affiliation(s)
- John D Hunter
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jamie A Cannon
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
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Yiannoullou P, van Dellen D, Khambalia H, Forgacs B, Tavakoli A, Murray D, Augustine T. Successful Management of a Ruptured Mycotic Pseudoaneurysm Following Pancreas Transplantation Using Bovine Pericardial Patch: A Case Report. Transplant Proc 2014; 46:2023-5. [DOI: 10.1016/j.transproceed.2014.06.051] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Gurrado A, Franco IF, Lissidini G, Greco G, De Fazio M, Pasculli A, Girardi A, Piccinni G, Memeo V, Testini M. Impact of pericardium bovine patch (Tutomesh(®)) on incisional hernia treatment in contaminated or potentially contaminated fields: retrospective comparative study. Hernia 2014; 19:259-66. [PMID: 24584456 DOI: 10.1007/s10029-014-1228-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 02/09/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This retrospective comparative study analyzes the outcome of patients affected by incisional hernia in potentially contaminated or contaminated field, treated by three operative techniques. METHODS 152 patients (62 M:90 F; mean age 65 ± 14 years) underwent incisional hernia repair (January 2002-January 2012) in complicated settings. Criteria of inclusion in the study were represented by the following causes of admission: mesh rejection/infection, obstruction without gangrene but with possible peritoneal bacterial translocation, obstruction with gangrene, enterocutaneous fistula or simultaneous presence of ileo- or colostomy. The patients were divided into three groups: A (n = 76), treated with primary closure technique; B and C (n = 38 each), with reinforcement by synthetic or pericardium bovine mesh (Tutomesh(®)), respectively. The prosthetic groups were divided into Onlay and Sublay subgroups. RESULTS Significant decreases in C vs A were observed for wound infection (3 vs 37%) and recurrence (0 vs 14%), and in C vs B for wound infection (3 vs 53%), seroma (0 vs 34%) and recurrence (0 vs 16%). Patients with concomitant bowel resection (BR) (43%) showed (all P < 0.05) an increase of overall morbidity (55 vs 33%) and wound infection rate (42 vs 24%) compared to cases without BR. Morbidity presented no significant differences in C-Onlay or Sublay subgroups. B-Sublay subgroup has (all P < 0.05) lower overall morbidity (20 vs 75%), wound infection (10 vs 68%) and seroma (0 vs 46%) than B-Onlay. CONCLUSIONS The pericardium bovine patch seems to be safe and effective to successfully repair ventral hernia in potentially contaminated operative fields, especially in association with bowel resection.
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Affiliation(s)
- A Gurrado
- Unit of Endocrine, Digestive, and Emergency Surgery, Department of Biomedical Sciences and Human Oncology, University Medical School,"Aldo Moro" of Bari, Policlinico, P.zza G. Cesare,11, 70124, Bari, Italy,
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Coleman S, Kerr H, Krishnamurthi V, Wee A, Gong M, Ghoneim I, Rabets JC. The use of bovine pericardium for complex urologic venous reconstruction. Urology 2013; 83:495-7. [PMID: 24275287 DOI: 10.1016/j.urology.2013.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 10/02/2013] [Accepted: 10/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To describe the use of bovine pericardium (BP) in several scenarios for venous patching and as a tubularized graft in urologic surgery. METHODS BP was used as patch or tubularized graft in 7 patients between 2010 and 2013. Clinical scenarios and operative indications were reviewed. We used BP as a patch graft for the inferior vena cava (IVC) (N = 3) and for the iliac venous system (N = 1) to restore venous outflow. Tubularized grafts were used (N = 2) to replace the left renal vein in oncology procedures and during renal autotransplantation (N = 1). Surgical technique is reviewed in detail. RESULTS We used BP as a venous patching in 4 cases and as a tubularized graft in 3 cases. There was no evidence of venous thrombosis of the replaced system with a mean of 14.8 months (range, 9-26) follow-up. CONCLUSION The use of BP as a patch or tubularized graft is an option for complicated urologic venous reconstruction. Although the follow-up interval is relatively short and this initial series small, our initial results are promising.
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Affiliation(s)
- Sarah Coleman
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
| | - Hannah Kerr
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | | | - Alvin Wee
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Michael Gong
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Islam Ghoneim
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - John C Rabets
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
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Long-term outcomes (>5-year follow-up) with porcine acellular dermal matrix (Permacol) in incisional hernias at risk for infection. Hernia 2013; 19:135-40. [PMID: 24129420 DOI: 10.1007/s10029-013-1165-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 10/01/2013] [Indexed: 01/25/2023]
Abstract
PURPOSE We reviewed retrospectively all patients undergoing abdominal wall reconstruction using porcine acellular dermal matrix (PADM) from 2004 to 2008 with follow-up assessment in 2012. Technique, short-term (infection, seroma, wound dehiscence), and long-term (mesh infection, recurrence) complications, and hernia recurrences were evaluated by physician examination ≥5 years postoperatively. RESULTS 56 patients at high risk for infection had elective operation; nine had non-elective operation for complications of prior incisional hernia/hernia repair. Operations were clean, clean-contaminated, contaminated, or grossly infected in 49, 32, 12, and 6%, respectively. Techniques of repair included 10 onlay (six reinforced primary closures, four bridging patches), 47 sublay (20 reinforced primary closures, 27 bridging patches), six inlay, and two sandwich (sublay and onlay). Early complications (≤30 days postoperatively) occurred in 19 of the 65 patients (29%), including two prosthetic dehiscences from fascial attachment, 13 wound infections, and 4 seromas. After a mean follow-up of ≥5 years in 59 of 65 patients, physician-reported incidences of infection requiring removal of mesh or hernia recurrence were 25 and 66%, respectively. Hernia recurrence occurred in 12 of 26 (46%) patients with a reinforced repair and 27 of 33 (82%) with patched repairs. Mesh infection occurred in 7 of 24 patients with sublay patch and in 4 of 19 sublay reinforcement. The greatest recurrence rate was in contaminated (71%) and grossly infected wounds (100%), while recurrence rate was 63% in clean and 63% in clean-contaminated wounds. CONCLUSIONS At ≥5 years of follow-up, use of PADM as a bioprosthesis in ventral hernia in high-risk patients is unreliable as a definitive repair in the majority of patients, but may provide satisfactory outcomes in some patients.
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