PubMed · 12437460
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Lucia Pozo, Enrique Jorquera, Salvador J Diaz-Cano. 2002. Multilobated abdominal nodule.. https://doi.org/10.1001/archderm.138.11.1509-a
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This study was designed to determine whether the novel spatial geometry of macroporous condensed poly(tetrafluoroethylene) (cPTFE) favorably affects the in vivo repair process. Specifically, the macroporous surface geometry and the reduced material thickness contribute to better healing characteristics. For this purpose, three other materials used for abdominal wall repair were selected, expanded poly(tetrafluoroethylene) (ePTFE), low-weight poly(propylene) (lwPP), and high-weight poly(propylene) (hwPP). Samples of each material (1 x 2 cm, n = 4) were implanted subcutaneously in rats for 7, 28, or 56 days. After sacrificing the animals, at each time point, the tissue implant sites were subjected to morphometric analysis and evaluation of inflammatory and wound-healing tissue characteristics. Although the fibrous capsule thickness did not significantly vary among the four materials (p > 0.05), cPTFE consistently led to the most mature fibrous capsule. However, ePTFE showed the greatest tissue-material integration. Both PP materials presented various levels of tissue integration, but they were characterized by significant early inflammation and increased foreign body reaction around the mesh openings, especially for hwPP. In contrast, cPTFE did not induce extensive inflammation or elevated foreign body reaction around its mesh openings. We conclude that cPTFE combines the inherent PTFE biocompatibility with low polymer surface area (large mesh openings, reduced material thickness) leading to a better inflammatory and wound healing response compared to available materials used in abdominal wall reconstruction.
BACKGROUND: According to the literature, conservative weight loss seems to be ineffective for morbidly obese subjects. Nevertheless, the significance of nonsurgical strategies for the treatment of morbid obesity is still unclear. PATIENTS: From 1999 to 2003, 197 reconstructive operations were performed on 120 morbidly obese patients. Initial body mass index (BMI) was higher than 35-40, and weight loss exceeded 40% of the original body weight. RESULTS: Gastric banding was performed in 66% of the patients; 34% reduced their body weight by conservative means. Conservative weight loss could be achieved at each level of BMI. CONCLUSION: Conservative weight loss is a valuable option for the treatment of morbid obesity in a selected group of patients. Condiolates candidates for conservative weight loss should be selected carefully by a multidisciplinary team with psychiatric expertise.
An ideal prosthesis for ventral hernia repair should minimize development of postoperative adhesions. This study evaluates adhesion formation following intraperitoneal implantation of acellular porcine dermal collagen (PDC) and polypropylene (PP) mesh in 16 rats. Implant placement alternated left/right. Sacrifice (4 or 12 weeks) was randomized. Methods included adhesion grading (extent, severity, required dissection method) and histological evaluation. At 4 weeks, 7 of 8 PDC specimens and 0 of 8 PP implants were adhesion-free; results were identical at 12 weeks. Four-week adhesions were less developed than 12-week adhesions. Histology showed mononuclear cell foreign body reaction and disorganized collagen deposition for PPs compared to infiltration with neovascular channels and qualitatively less intense foreign body reaction for PDCs. PDC exhibits fewer adhesions and more favorable cellular response than PP in the rat.