PubMed · 14796920
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B C BRYNJULFSEN. 1950-04-14. [Primary psoitis].. https://pubmed.ncbi.nlm.nih.gov/14796920/
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During 5 years from 1999 until 2003, our experience with 29 (100%) neonates managed for anterior abdominal wall defects is presented. Twenty-one (72%) neonates presented with gastroschisis and 8 (28%) neonates with giant omphaloceles. The male:female ratio was almost equal in gastroschisis (1:1) while a male predominance was observed in omphaloceles (6:1). A primary closure of the defect was possible in 5 (17%) cases and a single patch along with skin closure was achieved in a further 9 (31%) cases. In 15 (52%) neonates the defect was large and two patches were employed to sufficiently cover the defect. All patients (97%), except one (mortality due to extreme prematurity), were managed successfully. Depending upon the size of the defect and the metabolic condition of the neonate, the defect closure was completed after a mean of 85.7 days. Special protocols were created to manage the bovine pericard patches, which behaved differently to lyophilized dura patches previously used at our center. Integration of the patches was successful in 28 (97%) neonates; however, one neonate with gastroschisis presented significant challenges in the management. Bovine pericard patches are optimal biomaterials for the closure of anterior abdominal wall defects in gastroschisis and omphaloceles.
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.
AIMS: To investigate the different muscle activation patterns around the abdomino-pelvic cavity in continent women and their effect on pressure generation during a correct pelvic floor muscle (PFM) contraction and a Valsalva maneuver. METHODS: Thirteen continent women were assessed. Abdominal, chest wall, and PFM activity and vaginal and intra-abdominal pressure (IAP), were recorded during two tasks: PFM contraction and Valsalva whilst bladder base position was monitored on trans-abdominal ultrasound. A correct PFM contraction was defined as one that resulted in bladder base elevation and a Valsalva resulted in bladder base depression. RESULTS: Comparison of the mean of the normalized EMG activity of all the individual muscle groups was significantly different between PFM contraction and Valsalva (P = 0.04). During a correct PFM contraction, the PFM were more active than during Valsalva (P = 0.001). During Valsalva, all the abdominal muscles (IO (P = 0.006), EO (P < 0.001), RA (P = 0.011)), and the chest wall (P < 0.001) were more active than during PFM contraction. The change in IAP was greater during Valsalva (P = 0.001) but there was no difference in the change in vaginal pressure between PFM contraction and Valsalva (P = 0.971). CONCLUSIONS: This study demonstrates a difference in muscle activation patterns between a correct PFM contraction and Valsalva maneuver. It is important to include assessment of the abdominal wall, chest wall, and respiration in the clinical evaluation of women performing PFM exercises as abdominal wall bracing combined with an increase in chest wall activity may cause rises in IAP and PFM descent.