The influence of porosity on the integration histology of two polypropylene meshes for the treatment of abdominal wall defects in dogs.

Two types of monofilament polypropylene mesh with different pore sizes, mass densities and burst strengths were used to repair two identical paired full-thickness abdominal wall defects in ten dogs, in order to compare their integration histology 90 days after implantation. On one side a standard mesh, Prolene (Ethicon), was sutured to the borders of the defect, while on the other a new ultralightweight macroporous mesh, Mpathy mesh, was used. There was a significantly greater densitometric proportion of mature (type I) collagen (58.38%) for Mpathy mesh compared to Prolene (34.05%, P=0.01). Although Prolene has 3.6 times the burst strength of Mpathy mesh, the implanted tissue strength was marginally greater for Mpathy mesh. We conclude that Mpathy mesh gives a surgical repair that is at least as strong as that provided by Prolene, along with a higher concentration of mature collagen and less fibrosis (P=0.07), in this canine histology model.

The influence of differing pore sizes on the biocompatibility of two polypropylene meshes in the repair of abdominal defects. Experimental study in dogs.

Two types of monofilament polypropylene meshes of markedly different construction, configuration and pore size were compared and used to repair full-thickness muscle defects in the abdominal wall of 22 mongrel dogs to assess their biocompatibility with host tissues. The defects were repaired with Prolene (Ethicon) woven mesh (pore size = 164 x 96 microns) and with an experimental, extruded mesh called T mesh (pore size = 3 mm x 4 mm). On the 30th postoperative day, the animals were sacrificed, and the segments of the abdominal wall containing the implanted meshes were excised. Although the Prolene mesh had greater tensile strength before implantation, 30 days after implantation, the T mesh showed similar tensile strength to Prolene mesh. The collagen densitometry showed a significant increase of total and mature collagen type I deposition in the T mesh. This suggests that the increased mature collagen type I deposition significantly increases the tensile strength of the reinforced mesh tissue and that the larger pore in the T mesh contributed to this finding by allowing increasing fibber orientation within the pores as a result of in vivo tension.

Gastroatrial fistula following esophagectomy with esophagogastrostomy.

A case of gastroatrial fistula following resection of a carcinoma of the mid-esophagus and re-establishment of the alimentary tract with a cervical esophagogastrostomy is presented. Three episodes of moderate upper gastrointestinal hemorrhage secondary to chronic peptic ulcer of the stomach placed in the thorax occurred three years after the operation. At this time, the patient was also admitted to the hospital with diagnosis of pericarditis of unknown etiology. Three years later the patient had a massive and fatal episode of upper gastrointestinal bleeding.

Acesso posterior para correcao das hernias inguinal e femoral. / Posterior approach for repair of inguinal and femoral hernias

Em um periodo de um ano, 25 pacientes com hernia inguino-femoral foram submetidos a hernioplastia atraves do acesso posterior ou pre-peritoneal.Dezesseis pacientes eram do sexo masculino e nove do feminino. Oito hernias eram indiretas, nove diretas, duas indiretas e diretas e seis eram femorais.Em dois pacientes a correcao da hernia foi realizada atraves de uma incisao de Pfan nenstiel, uma feita para histerectomia e outra para cesariana. Durante um periodo de seguimento medio de oito meses nao foi observada nenhuma recidiva das hernias