PubMed Health⌕ Search

Biomedical subjects

Robert C Dinsmore

Publications and source records attributed to Robert C Dinsmore.

3 recordsLinked to original sources

Abdominal wall hernia repair: a long-term comparison of Sepramesh and Dualmesh in a rabbit hernia model.

Surgeons are faced with a wide variety of mesh products, which they can use to perform tension-free abdominal wall hernia repair. The purpose of this study is to compare Sepramesh (SM) and Dualmesh (DM) in terms of strength of tissue incorporation, mesh shrinkage, and adhesiogenesis. We conducted a prospective, randomized trial using 24 New Zealand White rabbits. Each animal underwent creation of a standardized ventral hernia defect and was randomized to receive either SM or DM repair. There were 12 animals in each study arm. Five months postoperatively, the animals were sacrificed and the hernia repairs were analyzed. Specimens were evaluated for strength of incorporation (SOI), mesh shrinkage, as well as the type and amount of adhesions. SOI for DM was not statistically different from SM (37.2N vs 40.8N). DM underwent significantly more shrinkage than did SM (50.8% vs 32.6%, P < 0.0001). Adhesions were predominantly omental in nature. DM demonstrated a greater amount of adhesed area as a percentage of the mesh (30.7% vs 25.2%), but fewer adhesions in terms of absolute area involved (636 mm2 vs 717 mm2). This difference was not statistically significant. Previous studies, terminated at 30 days, demonstrated an increased SOI for SM as compared to DM. This study shows that SOI for DM continues to increase over time such that it is equivalent to DM at 5 months. Though there is increased mesh shrinkage for DM, adhesions to the two materials are equivalent.

Animals↗

Subcuticular closure versus Dermabond: a prospective randomized trial.

2-Octylcyanoacrylate tissue adhesive (Dermabond, Ethicon, Inc, Somerville, NJ) is being used successfully for closure of minor lacerations. To date, however, there have been no studies evaluating its use in the operating room for surgical incisions. We conducted a prospective randomized trial to compare the closure of inguinal herniorrhaphy incisions using 2-octylcyanoacrylate tissue adhesive (Dermabond) with closures using 4-0 Monocryl (Ethicon, Inc) in a running subcuticular closure. A total of 46 incisions were randomized at the time of closure. Of these incisions 24 were randomized to Dermabond closure (TA) and 22 were randomized to subcuticular closure (SC). Performance measures included: time for closure, wound complications, and cosmesis. Cosmesis was evaluated by blinded evaluation of photographs of the incisions taken 4 weeks after surgery. Closure times for the TA group were faster than in the SC group (mean of 155 vs 286 seconds; P < 0.001). Wound complications were higher in the TA group (P = 0.045). Cosmesis was also felt to be better in the SC group with a score of 4.2 versus 3.88, but this did not reach statistical significance. Although the use of Dermabond did result in faster wound cultures it also resulted in an increase in wound complications. The difference in mean cosmetic score for each group was not statistically significant but trended toward better scores in the SC group. Based on these findings we do not feel Dermabond is an acceptable alternative to subcuticular suture closure in inguinal herniorrhaphy incisions.

Adult↗

Sepramesh vs. Dualmesh for abdominal wall hernia repairs in a rabbit model.

PURPOSE: To compare the relative strength of incorporation and adhesion formation for mesh hernia repairs performed with Sepramesh (Genzyme Corp., Cambridge, Massachusetts) and Dualmesh (WL Gore and Assoc., Flagstaff, Arizona). METHODS: A prospective randomized study was conducted using 30 New Zealand white rabbits, with 15 animals randomized to each limb. A standardized abdominal defect was created in each animal. The defect was then repaired using either Sepramesh or Dualmesh. Animals were sacrificed at 4 weeks. The area of adhesions was determined using digital analysis of inked specimens. Strength of incorporation was determined using an Instron Tensiometer. (Department of Clinical Research, D. D. Eisenhower Army Medical Center, Fort Gordon, GA 30905.) RESULTS: Sepramesh had a 30.6% stronger strength of incorporation compared with Dualmesh. (p = 0.011) The difference in area of adhesions was not statistically significant between the 2 products. CONCLUSIONS: The use of Sepramesh for abdominal hernia repairs provides a significantly stronger strength of incorporation without increasing the amount of adhesions as compared with Dualmesh.

Animals↗