El Diario de Pontevedra : periódico liberal: Ano XIV Número 3910 - 1897 xullo 14

Synthetic mesh surgery for both abdominal and urogenital hernia repair is often unsatisfactory in the long-term due to postoperative complications. We hypothesized that a semi-degradable mesh hybrid may provide more appropriate biocompatibility with comparable mechanical properties. The aim was to compare its in vivo biocompatibility with a commercial polypropylene (PP) mesh.72 rats were randomly allocated to either our new composite mesh (monofilament PP mesh knitted with polylactic-acid-fibers (PLA)) or to a commercially available PP mesh that was used as a control. 15, 90, and 180 days after implantation into the rat abdomen mesh tissue complexes were analysed for erosion, contraction, foreign body reaction, tissue integration and biomechanical properties.No differences were seen in regard to clinical parameters including erosion, contraction or infection rates between the two groups. Biomechanical properties including breaking load, stiffness and deformation did not show any significant differences between the different materials at any timepoint. Macrophage staining did not reveal any significant differences between the two groups or between timepoints either. In regard to collagen I there was significantly less collagen I in the PP group compared to the PP/ PLA group at day 180. Collagen III did not show any significant differences at any timepoint between the two groups.A PP/PLA hybrid mesh, leaving a low amount of PP after PLA degradation seems to have comparable biomechanical properties like PP at 180 days due to enhanced collagen production without significant differences in erosion, contraction, herniation or infection rates

A new bioabsorbable polymer film to prevent peritoneal adhesions validated in a post-surgical animal model

International audienceBACKGROUND: Peritoneal adhesions are a serious surgical postoperative complication. The aim of this study is to investigate, in a rat model, the anti-adhesive effects of a bioabsorbable film of polymer combining polyethylene glycol and polylactic acid. MATERIALS AND METHODS: Sixty-three animals were randomized into five groups according to the anti-adhesion treatment: Hyalobarrier\textregistered, Seprafilm\textregistered, Polymer A (PA), Polymer B (PB), and control. The rats were euthanized on days 5 and 12 to evaluate the extent, severity and degree of adhesions and histopathological changes. Three animals were euthanized at day 2 in PA, PB and control groups to observe the in vivo elimination. RESULTS: Macroscopic adhesion formation was significantly lower in the PA group than in the control group at day 5 (median adhesion score 0\textpm0 vs 9.6 \textpm0.5 p = 0.002) and at day 12 (0\textpm0 vs 7.3\textpm4 p = 0.02). Furthermore, median adhesion score at day 5 was significantly lower in the PA group than in the Seprafilm group (0\textpm0 vs 4.2\textpm 3.9 p = 0.03). Residence time of PA seems longer than PB. CONCLUSION: The PA bioabsorbable film seems efficient in preventing the formation of peritoneal adhesions

Images of the abdominal hernia model.

<p>1A. Schematic showing the different layers of the abdominal wall and mesh placement. 1B. Photograph of implantation of the PP/PLA mesh. 1C. Schematic of full thickness defect and mesh placement.</p

Macrophage staining in explanted meshes.

<p>A PP mesh with CD68 staining after 15 days. B. PP/PLA mesh with CD68 staining after 15 days. C. PP mesh with CD68 staining after 180 days. D. PP/PLA mesh with CD68 staining after 15, 90 and 180 days. Scale bars are 100 µm.</p

Biomechanical properties in rats implanted with PP and PP/PLA.

<p>A. Breaking load after 15, 90 and 180 days. B. Stiffness after 15, 90 and 180 days. C Deformation after 15, 90 and 180 days of implantation. Data are mean ± SD of n = 6 animals/ group *: p< 0.05.</p

Histological properties in rats implanted with PP and PP/PLA.

<p>A. CD68 staining percentage after 15, 90 and 180 days. B. Collagen I staining percentage after 15, 90 and 180 days. C. Collagen III staining percentage after 15, 90 and 180 days. D. Collagen ratio (%) after 15, 90 and 180 days of implantation. Data are mean ± SD of n = 6 animals/ group *: p< 0.05.</p

Ultrasound pregnancy diagnosis.

<p>At Day 21 post mating, by counting the number of foetuses (F). Test (Group A) and control group (Group B).</p

Operative procedure of the rabbits.

<p>A. Tubal curettage with a 3 mm curette; B. Instillation of 2 mL anti-adhesion solution; C. Rabbit bicornuate uterus: the left uterine tube is dilated by the instillation of 2mL anti-adhesion solution.</p

Safety and Efficacy of a Novel Barrier Film to Prevent Intrauterine Adhesion Formation after Hysteroscopic Myomectomy: The PREG1 Clinical Trial

Study Objective: To evaluate the safety and potential efficacy of a novel degradable polymer film (DPF) designed to act as a 7-day barrier to prevent intrauterine adhesions (IUAs) after hysteroscopic myomectomy. Design: A prospective single-arm, first-in-human clinical study. Setting: Multicenter study involving 6 centers in France, Belgium, and the Netherlands. Patients: Women aged 40 years or older with no plans to conceive who qualified for hysteroscopic myomectomy (at least 1 10-mm type 0, 1, or 2 myoma) and had a sounded length of the uterine cavity (fundus to exocervix) ranging between 6 cm and 9 cm were considered eligible for the study. Interventions: The DPF was inserted after hysteroscopic transcervical myoma resection. The women were followed up by a telephone call at 30 days and second-look hysteroscopy 4 to 8 weeks after the procedure. Measurements and Main Results: The chosen safety outcome measures were uterine perforation or cervical trauma at the time of the DPF insertion and unexpected fever, pain, or bleeding beyond 48 hours and up to 30 days after insertion, whereas the outcome measure for efficacy was the absence of IUAs on second-look hysteroscopy. A total of 23 women participated in the study. There were no incidents of uterine perforation or cervical trauma at the time of the DPF insertion. There were no reported adverse effects attributable to the DPF. On second-look hysteroscopy, 20 (87%) of the 23 women had no IUAs. Conclusion: The DPF is a novel, easy-to-apply, and acceptable device to prevent IUAs, with very promising initial safety and efficacy data

A preclinical evaluation of polypropylene/polylacticacid hybrid meshes for fascial defect repair using a rat abdominal hernia model - Fig 2

<p>Images taken at euthanization (180 days) frontal view showing normal wound healing of PP mesh with skin (Fig 2A) and without skin (Fig 2B); frontal view showing mesh erosion in a PP mesh (Figs 2C and D). Fig 2 D (sagittal view) and F (frontal view) showing herniation of a PLA mesh.</p