ABSTRACT
Abstract Purpose To Compare the extent and intensity of adhesions formed between the intra-abdominal organs and the intraperitoneal implants of polypropylene mesh versus polypropylene/polyglecaprone versus polyester/porcine collagen used for correction of abdominal wall defect in rats. Methods After the defect in the abdominal wall, thirty Wistar rats were placed in three groups (ten animals each) for intraperitoneal mesh implant: polypropylene group, polypropylene/polyglecaprone group, and polyester/porcine collagen group. The macroscopic evaluation of the extent and intensity of adhesions was performed 21 days after the implant. Results The polypropylene group had a higher statistically significant impairment due to visceral adhesions (p value = 0.002) and a higher degree of intense adherence in relation to polypropylene/polyglecaprone and polyester/porcine collagen groups (p value<0.001). The polyester/porcine collagen group showed more intense adhesions than the polypropylene/polyglecaprone group (p value=0.035). Conclusions The intraperitoneal implantation of polypropylene meshes to correct defects of the abdominal wall caused the appearance of extensive and firm adhesions to intra-abdominal structures. The use of polypropylene/polyglecaprone or polyester/porcine collagen tissue-separating meshes reduces the number and degree of adhesions formed.
Subject(s)
Animals , Male , Rats , Peritoneal Diseases/etiology , Polyesters/administration & dosage , Polypropylenes/administration & dosage , Surgical Mesh/adverse effects , Tissue Adhesions/etiology , Collagen/administration & dosage , Dioxanes/administration & dosage , Polyesters/adverse effects , Polypropylenes/adverse effects , Materials Testing , Collagen/adverse effects , Rats, Wistar , Abdominal Wall/pathology , Dioxanes/adverse effectsABSTRACT
Abstract Purpose: To evaluate the fibrosis induced by four different meshes: Marlex®, Parietex Composite®, Vicryl® and Ultrapro®. Methods: Histological cutouts of abdominal wall were analyzed with polarized light 28 days after the meshes implants and colorized by picrosirius to identify the intensity of collagen types I and III, and their maturation index. Results: When the four groups were compared, the total collagen area analyzed was bigger in groups A and D, with no difference between them. The collagen type I density was bigger in group A, with an average of 9.62 ± 1.0, and smaller in group C, with an average of 3.86 ± 0.59. The collagen type III density was similar in groups A, B and C, and bigger in group D. The collagen maturation index was different in each of the four groups, bigger in group A with 0.87, group B with 0.66, group D with 0.57 and group C with 0.33 (p = 0.0000). Conclusion: The most prominent fibrosis promotion in the given meshes was found on Marlex® (polypropylene mesh) and the Parietex Composite® (non-biodegradable polyester); the collagen maturation index was higher in the Marlex® mesh, followed by Ultrapro®, Parietex Composite® and Vicryl® meshes.
Subject(s)
Animals , Polyesters/adverse effects , Polyglactin 910/adverse effects , Polypropylenes/adverse effects , Surgical Mesh/adverse effects , Collagen/adverse effects , Abdominal Wall/pathology , Polyesters/administration & dosage , Polyglactin 910/administration & dosage , Polypropylenes/administration & dosage , Time Factors , Fibrosis/etiology , Fibrosis/pathology , Materials Testing , Tissue Adhesions/etiology , Tissue Adhesions/pathology , Collagen/administration & dosage , Models, Animal , Abdominal Wall/surgeryABSTRACT
Se presentan 35 enfermos operados de hernia inguinal utilizando el método de plug and patch, entre diciembre de 1999 y diciembre del 2000. Los tapones y parches fueron construidos artesanalmente mediante piezas de malla plana de polipropileno. El 77 (por ciento) de los pacientes fue operado electivamente, y existió un predominio del masculino sobre el femenino en relación de 6:1. En todos los casos se usó anestesia regional y antibioticoterapia profiláctica. La mitad de los pacientes mostraron hernias recidivadas una o varias veces. Según la clasificación de Gilbert modificada, 5 hernias eran tipo 2, 16 tipo 3, 6 tipo 4, 6 tipo 5 y 2 tipo 6 al ser hernias dobles o en pantalón. Sólo se presentaron complicaciones leves en 2 enfermos, recidivas, con un control que oscila entre 6 y 18 meses, y un seguimiento promedio de 12,4 meses del 100 (por ciento) de los casos(AU)
35 patients operated on of inguinal hernia by the plug and patch method from December, 1999, to December, 2000, were presented. The plugs and patches were made by hand, using pieces of flat polypropylene mesh. 77 percent of the patients underwent elective surgery. There was a predominance of males over females with a ratio of 6:1. Regional anesthesia and prophylactic antibiotic therapy were used in all cases. Half of the patients had hernias that had relapsed one or more times. According to the modified Gilbert's classification, 5 hernias were type 2; l6, type 3; 6, type 4; 6, type 5; and 2, type 6, on being double hernias. Mild complications were just observed in 2 patients, relapses, with a control that ranges between 6 and 18 months, and an average follow-up of 12.4 months of 100 percent of the cases(AU)
Subject(s)
Humans , Male , Female , Surgical Mesh/adverse effects , Hernia, Inguinal/surgery , Hernia, Inguinal/diagnosis , Polypropylenes/administration & dosage , Anti-Bacterial AgentsABSTRACT
El objetivo de este trabajo, es demostrar que la reparación primaria en un solo plano con polipropileno, es efectiva y segura, para el manejo de las lesiones penetrantes de colon cuando se compara con la técnica convencional en dos planos; para esto se utilizaron, animales de experimentación , alos cuales se le practicó perforación en un segmento del colon y fueron reparados con dichas técnicas. Se evaluó el tiempo empleado para la realización de cada una de las técnicas, el cual fue menor en un solo plano, la respuesta a la tolerancia de la vía oral y la restitución del tránsito intestinal fue similar en ambas técnicas. No hubo lugar de línea de sutura en ninguno de los grupos experimentales y en cuanto a la estenosis de la luz intestinal se observó una mayor proporción no significativa, en el grupo reparado con la técnica convencional. En los estudios histopatológicos se observó mayor fibrosis, presencia de úlcera, respuesta inflamatoria, y por ende mayor disrupción de al capa muscular, cuando se utiliza la técnica convencional. Se concluye que la técnica en un plano con polipropileno es efectiva y segura para las reparaciones de las heridas penetrantes de colon , al compararlas con la técnica convencional