Long-term outcome (5-10 years) after non absorbable mesh insertion compared to partially absorbable mesh insertion for anterior vaginal wall prolapse repair

ABSTRACT Objective: To evaluate long-term (5-10 years) outcomes of Minimally Invasive Surgical (MIS) kit insertion with Prolift® (non-absorbable) mesh compared to the use of Prolift M® (partially absorbable), for anterior vaginal wall prolapse repair. Study design: In this retrospective study we compared women undergoing MIS kit Prolift® insertion (n=90) vs. Prolift M® insertion (n=79) for anterior vaginal wall prolapse repair between 2006 and 2012 at our Institution. A number of 169 women fulfilled the inclusion criteria and were included in the study. Results: During the study period 128 women (76%) completed full follow-up; of them 58 (73%) following MIS kit Prolift® insertion, and 70 (88%) following MIS kit ProliftM® insertion. There was no significant difference between the Prolift® and Prolift M® regarding parity (3.04 vs. 2.88, p=0.506), presence of hypertension (24.1% vs. 39.1%, p=0.088), diabetes mellitus (3.4% vs. 11.6%, p=0.109), or urinary stress incontinence (39.7% vs. 47.1%, p=0.475). All participants had been diagnosed with POP grade 3 or 4 before the procedure. No significant complications during the procedure or postoperative period were identified in the study groups. The follow-up period was at least five years in duration for both groups. Both groups were comparable according to questionnaires focused on function and satisfaction. Conclusion: Patients undergoing MIS kit Prolift® and Prolift M® insertion for anterior vaginal wall prolapse repair had comparable early and late postoperative outcomes. No differences in patient's function and satisfaction between the two groups were identified. According to our findings, there is no superiority to either of the two studied mesh devices.

Ruptura de tornillo tibial interferencial biodegradable posterior a reconstrucción de ligamento cruzado anterior / Broken bioabsorbable interference tibial screw of anterior cruciate ligament reconstruction

Se presenta un reporte un caso con una ruptura de tornillo interferencial biodegradable tibial luego de la reconstrucción de ligamento cruzado anterior (LCA) con injerto cuádruple autólogo de semitendinoso y recto interno. Doce meses postoperatorios luego de una recuperación satisfactoria inicia con síntomas de bloqueo y dolor de rodilla. La Resonancia magnética (RM) mostró ruptura del tornillo tibial sin pérdida de la ubicación ni continuidad de la plástica de LCA. Se realizó extracción de la parte rota del tornillo por vía artroscópica. La paciente tuvo una recuperación completa de su rodilla. Éste caso describe posibles causas de ruptura del tornillo biodegradable y se sugiere tomar en cuenta los cuidados necesarios para evitar dicho problema.

We report a case of broken screw from the tibial site of anterior cruciate ligament reconstruction using an autologous ipsilateral semitendinosus-gracilis quadruple graft. Twelve months after initially successful ACL surgery the patient felt locking symptoms and knee pain. MRI showed a broken bioabsorbable interference tibial screw without loss of location or continuity of the ACL graft. At revision arthroscopy the broken part was removed. The patient had full recovery. This case describes possible causes of bioscrew rupture in ACL surgery and we suggest the necessary precautions to avoid this problem.

Inflammatory reaction and tensile strength of the abdominal wall after an implant of polypropylene mesh and polypropylene/poliglecaprone mesh for abdominal wall defect treatment in rats

PURPOSE: To compare the inflammatory reaction and the growing resistance of the abdominal wall with the use of poliglecaprone meshes and polypropylene meshes associated with poliglecaprone in the correction of abdominal defects. METHODS: Seventy-seven Wistar rats were divided into three groups: CG (non-operated animals: EG (polypropylene mesh) and UG (polypropylene and poliglecaprone mesh). A muscular and aponeurotic defect was formed and treated according to the group. Evaluations were made after 4, 7, 14, 28 and 56 days. The resistance and inflammatory pattern were studied. RESULTS: There was a gradual and significant gain in resistance, regularly in the EG and irregularly in the UG, which was lower on the 14th day (p=0.008). The inflammatory reaction was acute and more intense in the UG on the fourth day. At all other times, the inflammatory pattern was acute to chronic, similar in both groups, with minimum intensity on the 56th day. CONCLUSION: The greater resistance offered by the polypropylene mesh was regular and ascending, stabilizing on the 28th day, while that of the polypropylene/poliglecaprone was not even. In the end, the resistances were similar. The inflammatory response was greater in the UG on the fourth day and similar at all other times. .

Evaluación de la respuesta hística del beta fosfato tricálcico (Biograft-G) como implante óseo / Histological evaluation of tricalcium beta phosphate (Biograft-G) as bone implant

Con el objetivo de determinar la histocompatiblidad y las propiedades de osteoconducción y biodegradación del Biograft-G (beta fosfato tricálcico sintético) obtenido por el Centro de Biomateriales de la Universidad de La Habana, se usaron para esta experiencia, 10 perros Beagle, a los cuales se les realizaron implantes de Biograft-G en fémur y mandíbula, con sus correspondientes controles. Estos animales fueron sacrificados en los siguientes periodos: a los tres y seis meses; y al año y dos años de implantados. Se obtuvo muestras de tejido en bloque del hueso implantado las cuales se fijaron en formol neutro y posteriormente procesadas, previa descalcificación, por el método de inclusión en parafina y coloreadas con Hematoxilina y Eosina. El estudio se realizó con microscopio óptico. Los resultados permitieron determinar que el Biograft-G resultó ser un material histocompatible, osteoconductor y biodegradable(AU)

With the aim to determine the histocompatibility, osteoconduction properties and biodegradation of synthetic tricalcium beta phosphate (Biograft-G) obtained in the Biomaterials Centre of Havana University we developed an experimental study using 10 Beagle dogs in which were placed Biograft-G implants in femur and jaw bones with their corresponding controls. The animals were sacrificed in three different periods: 3, 6 months, one and two years time of implantation. Block bone samples were obtained, fixed in 10 percent neutral formalin, decalcified and processed with the paraffin inclusion method and stained with Haematoxylin and Eosin. The study was carried out with optical microscope. We conclude that, according to the results obtained, Biograft-G is a histocompatible, osteoconductor and biodegradable material(AU)