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At least 19 recordsLinked to original sources
PubMedDate not supplied

Resection of plantar fibromatosis with interposition of Marlex surgical mesh.

Successful surgical resection of plantar fibromatosis is often difficult because of high recurrence rates and frequent postoperative complications. In this study, two different surgical procedures, both used to excise plantar fibromatosis permanently, are compared and evaluated. These procedures are local resection of plantar fibromatosis and local resection of plantar fibromatosis with interposition of Marlex surgical mesh. A 10-year follow-up study comparing the results of both procedures is presented. Interpretation of our results indicates that recurrence of plantar fibromatosis after surgical resection can be significantly reduced by utilizing Marlex surgical mesh.

Adult↗
PubMed2004

Design of surgical meshes - an engineering perspective.

There is an increasing use of meshes to surgically repair or reconstruct anatomical defects. The surgical mesh firmly augments the debilitated area, provides a tension-free repair and facilitates the incorporation of fibrocollagenous tissue into the surgical mesh. However, the variant of mesh that facilitates best surgical practice is controversial. Surgical meshes have been predominantly designed with greater emphasis being placed on enhancing the biocompatibility of surgical meshes rather than on the engineering parameters. There is abundant evidence indicating a relationship between post-operative complications and the mesh design. Yet, the design of surgical meshes from an engineering perspective has to come to fruition. This article endeavours to present a synopsis of the current state of the science of surgical meshes, their clinical applications and the current trends in research.

Equipment Design↗
PubMed2005

New experimental approach to study host tissue response to surgical mesh materials in vivo.

Implantation of surgical meshes is a common procedure to increase abdominal wall stability in hernia repair. To improve biocompatibility of the implants, sophisticated in vivo animal models are needed to study inflammation and incorporation of biomaterials. Herein, we have established a new model that allows for the quantitative analysis of host tissue response and vascular ingrowth into surgical mesh materials in vivo. Ultrapro meshes were implanted into dorsal skinfold chambers of Syrian golden hamsters. Angiogenesis, microhemodynamics, microvascular permeability, and leukocyte-endothelial cell interaction of the host tissue were analyzed in response to material implantation over a 2-week period using intravital fluorescence microscopy. Mesh implantation resulted in a short-term activation of leukocytes, reflected by leukocyte accumulation and adherence in postcapillary venules. This cellular inflammatory response was accompanied by an increase of macromolecular leakage, indicating loss of integrity of venular endothelial cells. Angiogenesis started at day 3 after implantation by protrusion of capillary sprouts, originating from the host microvasculature. Until day 10, these sprouts interconnected with each other to form a new microvascular network. At day 14, the inflammatory response had disappeared and the vascular ingrowth was completed. Histology confirmed the formation of granulation tissue with adequate incorporation of the mesh filaments within the host tissue. We conclude that this novel model of surgical mesh implantation is a useful experimental approach to analyze host tissue response and vascular ingrowth of newly devised materials for hernia repair.

Animals↗
PubMed2000

[Standardisation of surgical mesh implantation in incisional hernia].

PURPOSE: To describe the relation between risk factors, postoperative complications, recurrence rates and satisfaction before and after the introduction of Stoppas technique in patients operated for incisional hernia with implantation of a surgical mesh. MATERIAL AND METHODS: The records of 27 patients undergoing an incisional hernia repair using a surgical mesh in the period 1.1.1993-30.6.1998 were reviewed, and 18 living patients were examined. RESULTS: Among the eight patients operated using Stoppas technique there were no postoperative complications but one recurrence, and among the ten patients operated without using a specific standard technique there were five with complications and four with recurrence. CONCLUSION: Operation for incisional hernia using implantation of a surgical mesh seems to require a standard surgical technique and care must be taken in patients with risk factors.

Adult↗
PubMed2000

[Surgical mesh implantation in incisional hernia. A historical follow up study].

AIM OF STUDY: To describe risk factors, recurrence rates, morbidity and satisfaction in patients operated for incisional hernia with implantation of a surgical mesh. MATERIAL AND METHODS: The records of 60 patients undergoing an incisional hernia repair using a surgical mesh in the period 1.1.1993-30.6.1998 were reviewed, and 49 living patients were examined. RESULTS: During a mean follow-up of 27 months, patients with preoperative risk factors had more complications and recurrences. Overall recurrence rate was 14%. Ninety-six percent were satisfied with the operation and 90% wanted the same operation in case of recurrence. CONCLUSION: Operation for incisional hernia using implantation of a surgical mesh is a safe and well tolerated procedure, care must be taken in patients with risk factors.

Follow-Up Studies↗
PubMed2003

Occupational rehabilitation following open mesh surgical repair of an inguinal hernia.

BACKGROUND AND PURPOSE: The purpose of this case report is to describe an occupational rehabilitation program for a person whose work-related inguinal hernia was surgically repaired. CASE DESCRIPTION: A 35-year-old baggage service attendant acquired an inguinal hernia while lifting at work. Postoperatively, the patient had discomfort in the groin, weakness of the lower extremities and trunk, limited ability to walk, and a decreased ability to work due to impaired lifting tolerance. OUTCOMES: Following postoperative rehabilitation, the patient was able to return to full-time, full-duty work. DISCUSSION: This case report describes occupational rehabilitation as a method to treat patients with work-related inguinal hernias following surgical repair.

Adult↗
PubMed1985

Characterization of morphologic and mechanical properties of surgical mesh fabrics.

The objective of this study is to use standard testing methods to characterize the currently available synthetic mesh fabrics in terms of their chemical, physical, mechanical, and morphologic properties. Three commonly used surgical mesh fabrics, Mersilene (Ethicon), Marlex (Davol), and Teflon (USCI), were used, and the tests reveal that they differ from one another chemically as well as configurationally. The experiment included an identification of the structure of the yarn and fabrics; a measurement of the porosity, pore size and shape; and a determination of tensile and bursting strength, flexural rigidity, and wrinkle recovery. A wide variation in structure and performance was observed among the three mesh fabrics. Mersilene mesh fabrics have the highest relative porosity, while Marlex and Teflon meshes have an equivalent, but lower value. Marlex meshes have the highest tensile and bursting strength followed by Teflon and Mersilene meshes. All three meshes have one common strength characteristic--a distinctive difference in tensile strength between the wale and course directions. Marlex mesh fabrics exhibit an immense flexural rigidity and poor wrinkle recovery, due mainly to the monofilament structure of the yarn. Mersilene and Teflon mesh fabrics have similar but considerably lower, flexural rigidity than Marlex. Thus, it is evident that the chemical nature of the constituent fibers, as well as the yarn and fabric structure, have a great effect on the performance of the resulting mesh fabrics. The availability of this characterization data can serve as the basis for a surgeon's selection of the most appropriate commercial surgical mesh fabric for each case, as well as to provide a foundation for the subsequent comparison of their in vivo performance.

Materials Testing↗
PubMed2006

Biocompatible properties of surgical mesh using an animal model.

AIM: To study the biocompatibility of surgical meshes for use in pelvic reconstructive surgery using an animal model. METHODS: Eight different types of mesh: Atrium, Dexon, Gynemesh, IVS tape, Prolene, SPARC tape, TVT tape and Vypro II, were implanted into the abdominal walls of rats for 3 months' duration. Explanted meshes were assessed, using light microscopy, for parameters of rejection and incorporation. RESULTS: Type 1 (Atrium, Gynemesh, Prolene, SPARC and TVT) and type 3 (Vypro II, Dexon and IVS) meshes demonstrated different biocompatible properties. Inflammatory cellular response and fibrosis at the interface of mesh and host tissue was most marked with Vypro II and IVS. All type 1 meshes displayed similar cellular responses despite markedly different mesh architecture. CONCLUSIONS: The inflammatory response and fibrous reaction in the non-absorbable type 3 meshes tested (IVS and Vypro II) was more marked than the type 1 meshes. The increased inflammatory and fibrotic response may be because of the multifilamentous polypropylene components of these meshes. Material and filament composition of mesh is the main factor in determining cellular response.

Absorbable Implants↗
PubMed2006

[TVT (transvaginal mesh) surgical method for complex resolution of pelvic floor defects].

OBJECTIVE: Assessment of the effects of a new surgical method for complex resolution of pelvic floor defects. SUBJECTIVE: Case study. SETTING: Department of Obstetrics and Gynaecology, Bata Hospital, Zlín. METHODS AND RESULTS: We evaluated the procedures and results of the new TVM (transvaginal mesh) surgical method which we used in a group of 12 patients. Ten patients had vaginal prolapse following vaginal hysterectomy and in two cases there was uterine prolapse and vaginal prolapse. Only in one case there was a small protrusion in the range of 0.5 cm which we resolved by removal of the penetrated section. The resulting anatomic effect was very good in all the cases.

Female↗
PubMedDate not supplied

Surgical mesh as a scaffold for tissue regeneration in the esophagus.

BACKGROUND: Textiles in the form of surgical meshes are widely used in hernia surgery. Their porous structure allows tissue infiltration to incorporate the fabric for complete healing and device stabilization. This study was aimed to reconstitute the esophageal wall and to investigate the functional and histological consequences of a new, non-absorbable polyvinylidene fluoride (PVDF) mesh and an absorbable polyglactin 910 (Vicryl((R))) mesh. METHODS: Semicircular esophageal defects of 0.5 x 1 cm were created 2 cm proximal of the cardia in 10 rabbits. This gap was bridged using either polyglactin 910 or PVDF and additionally covered by omental wrapping. The clinical outcome was observed by clinical observation, regular esophagoscopies and X-ray contrast medium examinations. Local tissue regeneration was verified by light microscopy and immunohistochemistry. RESULTS: After an observation period of 3 months we found no anastomotic strictures, complete mucosal regeneration, minimal inflammation reaction and initial regeneration of the muscle layer for the PVDF group. Within the polyglactin 910 group, three patch failures with consecutive anastomotic leakage occurred. CONCLUSION: The results indicate that PVDF mesh structure gives the opportunity of local tissue regeneration in the esophagus. Though re-epithelialization and muscle cell ingrowth could be detected for absorbable polyglactin 910 mesh, this implant was accompanied by a high and early rate of anastomotic leakage.

Animals↗
PubMed1989

Porosity of surgical mesh fabrics: new technology.

A new method using an image processing system developed in our laboratories is used to measure the pore size in Mersilene, Marlex, and Teflon surgical meshes. All three meshes appear to have sufficiently large pores and should facilitate tissue growth/attachment. Results obtained in this study are compared to results of an earlier paper.

Image Processing, Computer-Assisted↗
PubMed2006

Characterization of the structure and properties of authentic and counterfeit polypropylene surgical meshes.

A counterfeit version of the Ethicon Prolene polypropylene mesh was distributed to hospitals and clinics and unintentionally implanted into patients undergoing tension-free hernia repair. On December 19, 2003, the Food and Drug Administration (FDA) issued a public health web notification indicating that the counterfeit mesh was not sterile or safe to use. To develop safety recommendations for patients with the counterfeit mesh implant, we compared the counterfeit's structural, physical, chemical and mechanical properties with polypropylene meshes previously cleared by FDA. The mesh fibers for all the products tested were found to have similar chemical and physical properties. The mechanical properties were directly related to the knitted structure (loop size, repeat distance, fabric tightness) and the porosity. Extracts from the counterfeit mesh passed cytotoxicity screening tests. The FDA further recommended that if the mesh had been inadvertently implanted, then those patients should be monitored as would be the practice for any patient with an implanted surgical mesh.

Herniorrhaphy↗
PubMedDate not supplied

[Implantation of alloplastic surgical mesh in hernia repair. An anterior pre-peritoneal approach].

Despite the fact that more than one century has passed from the first radically performed surgery of inguinal hernia by Bassini there is still an appreciable problem in repair of abdominal hernias. In reconstructive-plastic surgeries, without the application of prosthesis, recurrences amount to 10% in primary repairs, and up to 20% or more in repairing recurrences. Synthetic surgical meshes have been used in repair of hernias for over 4 decades. During that period, extensive experience has been gained in use of various kinds of nonabsorbent and absorbent synthetic meshes in either experimental animals or in clinical investigations. Following our experience with one hundred patients managed with dacron "Mersilene" mesh, throughout the period 1960-1974, we were very rigorous, i. e. we used synthetic meshes only in cases when defect could not be repaired by the tension-free living tissue from the surrounding area. Today, synthetic meshes are routinely used for almost all kinds of hernias and even in primary reconstruction of inguinal and femoral hernias without the plastic surgery of the surrounding tissue. During the past 20 years, Lichtenstein IL, Shulman AG, Parviz KA et al. from Los Angeles have been recommending "the tension-free hernioplasty" for the repair of all kinds of primary and recurrent hernias with the results (infections, recurrences) being far more better than those achieved with the old classical operations. At present, the polypropylene "Marlex" mesh sewn with monofilamented polypropylene threads yields very good results and should be found in the hands of every surgeon practitioner.

Hernia, Inguinal↗
PubMed2000

New surgical mesh.

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Biocompatible Materials↗