1.4.8 Performance of synthetic meshes Synthetic meshes have been widely used through decades as a routine to solve also the most complicated cases, even in cases of clean-contamination with severe comorbidity . The biological response to prosthetic meshes can be characterized by the foreign body reaction, the formation of collagenous tissue, neoperitonealization and neovascularization. Different meshes differ in their host tissue integration. Some studies reported signifficant less strength of host tissue integration for ePTFE or ePTFE-containing meshes than other mesh materials [203-205]. ePTFE (DualMesh®) has been compared with polypropylene (SeprameshTM) in two experimental studies. After 1 month, SeprameshTM showed 30% stronger …show more content…
ParietexTM and ParieteneTM Composite showed to produce fewer adhesions than Sepramesh® . Another study comparing adhesion formation reported Sepramesh® to be superior to ComposixTM . An experimental study compared Prolene®, DualMesh®, Ultrapro®, TiMesh®, SeprameshTM, ParietexTM Composite, Proceed® and Tutomesh® regarding adhesion formation (7 and 30 postoperative days). On postoperative day 30, ParietexTM Composite, Tutomesh® and SeprameshTM reported the smallest amount of adhesions. In a recent study, the adhesion profiles of MarlexTM and Bard® Soft either exposed directly to the viscera or protected with Vicryl® mesh were evaluated. MarlexTM showed smallest adhesion score and the use of Vicryl® as a separating layer did not reduce adhesions . Few human studies concerning intraperitoneal adhesions have been published. Balique et al.  evaluated adhesion formation by ultrasound examination. 29 of 80 patients had hernia repair using ParietexTM Composite. After 12 months, 86% of the patients were adhesion free. Another study compared ventral hernia repair with ParietexTM Composite and Mersilene®. 77% of the patients in the Mersilene® group exhibited visceral adhesion to the mesh, while 18% of the patients in the ParietexTM Composite group presented this complication . The occurrence of adhesions in patients who previously had a hernia repair with ePTFE mesh (DualMesh®) was investigated by Koehler et al. . 91% of the patients were described
Kappelman surgically removed the PROCEED Ventral Mesh Patch. “The previous incision was opened wider, deepened down through the subcutaneous tissue. There was noted to be no tunneling and no evidence of necrotizing fasciitis. The PROCEED Ventral Mesh disk was removed and after removal, there was noted to be material emanating from the wound. Further exploration of the wound revealed a 1 cm defect in the colon that appeared to have been caused by erosion of the cecum by the edge of the PROCEED Ventral Mesh disk”. (EXHIBIT B) “It appeared that the edge of the mesh may have been in contact with the colon and that’s what caused the erosion”. Dr. Kappelman “saw the defect in the colon and that’s where the erosion occurred, since it wasn’t there before”. As far as Dr. Kappelman knew, the PROCEED Ventral Mesh disk was designed, “originally it was a sutureless material because of the two straps that are utilized to anchor it, pull it up and anchor it, it did not have to be sutured intra-abdominally. You are only suturing the straps to the surrounding
Patients that undergo surgery having to do with pelvic organ prolapsed repair with a surgical mesh are at greater risk for mesh complications than other treatments that put you under.
It is a safe and reliable procedure that shows successful results. The stitches are also absorbable that are not required to be removed. The procedure takes the maximum of 1.5 hours and is allowed to go home in a few hours. Patients recover very quickly after the operation.
• You will be re-evaluated in the operating room in the next few days. At this time, further treatments or wound closure will be performed. This may include stitches (sutures) and a procedure to cover an area of damaged or missing skin with a piece of healthy skin (skin
If a cut (incision) was necessary to remove this, it may have been repaired for you by your caregiver either with suturing, stapling, or adhesive strips. These keep together the skin edges and allow better and faster healing.
The use of repeated applications of tetracaine 1% to try to loosen epithelial tight junctions has been tried (Chan et al., 2007). Other investigators have utilized limited full-thickness epithelial debridement in a grid pattern, with remaining islands of intact epithelium to aid post-operative epithelial healing (Samaras and Lake,
The prosthetic design is associated with new materials development that will have biological compatibility that is accetable. The new materials should have better physical properties, that results in the better integration into bones along with better wear characteristics. Designs have been developed with the composites of plastics, metals and elements that confer flexibility as well as strength at the same time. Cement less prosthetic designs aid in the greater in growth of bone that would assure better and long term fixation. The designs should be developed in such a way that there is a minimal loosening, metallosis and osteolysis. Technologies need to be developed in such a way that devices and designs should be economical at reasonable costs that would reduce the burden of health care. Composites are applied in many areas of orthopaedics. and the major advantage of using composites is their biocompatibility and exceptional strength characters. Due to their range of application, there is scope for innovation. The innovation in the area of prosthetics is definitely offers the prospects of more and more natural
In addition polymers composites have shown to be able to induce bone formation and enhance bone cell adhesion . Table 1 shows the summary of bone graft substitute materials, which are also discussed below.
Initially, for the purpose of denture base, vulcanized rubber (vulcanite) has been in use. It was introduced in the year 1855 to the field of dentistry (Tandon et al., 2010). However, there were several issues faced with respect to its fabrication as well as the aesthetics. With this, the year 1937 saw the advent of PMMA which replaced vulcanite as it had enhanced properties (Machado et al., 2007). It also was less expensive than vulcanite and aesthetically more pleasing. From then on, PMMA has been in use. Recently, additional polymers such as nylons, vinyl acrylic and light activated urethane dimethymethcarylate have been evaluated for use as denture base materials (Diaz-Arnold et al., 2008). Even if these materials do exhibit very capable properties, none of them have been deemed superior to PMMA. However, clinical studies (Ray et al., 2014; Dhiman & Chowdhury, 2009) have reported midline fractures to be a common problem in maxillary complete dentures due to fatigue
Interpositional materials also have been used, such as abdominal fat or buccal fat pad, in an attempt to prevent relapse after excision. The purpose of a fat graft is to obliterate dead space to prevent hematoma formation and spark a repeat
A widely acknowledged criterion for the technical quality of RP is the positive surgical margin (PSM) rate, and this rate has been shown to affect the risk of biochemical recurrence (BCR) after surgery. Although previous reports demonstrated predictors that may prolong operation time (OT) and raise the rate of positive surgical margin (PSM), there are no studies so far that evaluated the practical impact of adhesion of the Denonvilliers’ fascia due to prostatic bleeding by biopsy procedure on the PSM rate. Peri-prostatic and/or intra-prostatic bleeding is one of the most common complications seen in of the biopsies for prostatic gland. We reviewed patients’ operation record who had adhesion of the Denonvilliers’ fascia and found out most of
Internal fixation devices in the past had been made of stainless steel or titanium, but with problems resulting from those permanent devices, an innovative approach is being considered. Bioresorbable implants are a possible replacement to the original implants that would eliminate the need for removal, which has shown to be a problem for traditional implants.