U Klinge

..Whereas the addition of polyglactin filaments appears to be favourable, the coating of polypropylene with polyglactin seems to hinder the incorporation of the mesh...

..Furthermore, it might explain the high recurrence rates of hernia repair by simple closure, as a repetition of the primarily failing technique, and the improvement by the additional use of alloplastic material...

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..The absence of changes of the expression of collagenases (MMP-1, MMP-13) and the constant levels of fibronectin underline the central role of collagen synthesis for the development of indirect or direct hernias...

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..These complications are accompanied by an intense inflammatory infiltrate around the polymer fibres. To characterize this effect, the response to polypropylene fibres in the absence of tension was examined...

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..Although laparotomy closure is associated with a cumulative 15% failure rate, the effect of different suture techniques and materials on the ultrastructural composition of the healing incision has not been investigated...

..951, p = 0.049), there was no relation to the expression of collagenases (MMP-1/MMP-13) with regard to the amount of inflammatory and connective tissue formation despite partly significant differences between implanted polymers...

..The aim of the present study was to investigate the gas-dependent effects of pneumoperitoneum on wound healing distant from the abdomen...

..The following study was designed to investigate the adhesive potential of different polypropylene meshes when placed in direct contact with intestine...

..No significant improvement of biocompatibility was found when analyzing the effect of titanium coating compared to the pure polypropylene mesh structure...

..This study was designed to evaluate the influence of this additional supplementation on the biocompatibility in a rodent animal model...

..Therefore, a new mesh was constructed of absorbable polydioxanon monofilaments (PDS) with increased porosity and longer degradation time...

..Furthermore, these results might explain the poor results of a mesh-free hernia repair, which again builds up scar tissue of inadequate collagen composition and strength...

..The aim of this study was to identify potential parameters as predictors for seroma formation after incisional hernia mesh repair...

..Therefore the development of bioactive mesh materials to achieve a local modification of the scar formation to improve patients outcome is advisable...

..To approach biocompatibility of surgical meshes we therefore examined the infiltrate of these cells as well as the proliferation rate in response to different clinically applied materials...

..A significantly decreased foreign body granuloma formation compared to the pure PVDF mesh group was found. In vitro analysis showed efficient antibiotic effects of the Gentamicin supplementation compared to the pure PVDF mesh...

..Furthermore, the characteristics of drainage liquid were compared to the characteristics of seroma liquid...

..The aim of this study was to evaluate the effect of different mesh structures on integrity of the vas deferens...

..As it has been suggested that polyglactin induces fibroplastic reactions and wound complications, this study was designed to evaluate the long-term tissue reaction to polyglactin in the Vypro II mesh...

..To investigate the adhesive potential induced by the biomaterial, an animal model was performed. In addition, the influence of coverage by omentum or a polyglactin barrier was investigated...

..The aim of the present study was to further characterise the scarring process in such patients...

..There are currently no biomechanical data available for evaluation of the quality of adhesion achieved with fibrin sealant during Lichtenstein hernia repair...

..Mesh techniques are the methods of choice for the repair of incisional hernias since these are due to the formation of unstable scar tissue...

..The quality of the ECM deposition as determined by collagen type I/III ratio is impaired in general, whereas the quantity of ECM deposition is markedly influenced by the kind of mesh material...

..Mesh repair in hernia surgery has become an integral component. Although meshes made of PVDF are already in clinical use, so far no data of long-term biocompability are available...

..Analyzing the results confirmed that construction of hernia meshes made of PVDF could be an advantageous alternative to the commonly used materials due to an improved biostability. lowered bending stiffness and a minimum tissue response...

..As monocytes take a key position in the inflammatory foreign body reaction, their specific release of cytokines was investigated in vitro after incubation with alloplastic materials...

..Therefore, an early postoperative return to normal activity can be recommended...

..Due to previous observations of an altered collagen metabolism in hernia patients, a severe connective-tissue pathology in the infant was hypothesised...

..However, in particular studies of collagen accumulation in nerves, species dependant differences have to be considered...

..Nevertheless, in the complex situation requiring a temporary abdominal wall closure, use of absorbable mesh material is common and represents the state of the art...

..CONCLUSION: The results suggest that helium pneumoperitoneum may ameliorate wound healing within the abdominal wall and could therefore represent a beneficial gas for endoscopic hernia repair...

..Three-dimensional stereographic examinations were well in accordance with our clinical findings. Our data support the hypothesis that the use of low-weight large-pore meshes is advantageous for abdominal wall function...

..The aim of this study was to investigate the scientific value of this technique in mesenteric ischaemia in a rabbit model of controlled mesenteric ischaemia and reperfusion...

..An overview of the literature is provided, and the consequences for surgical practice are discussed...

..As with other incisional hernias, the hernia repair using mesh implantation in the retromuscular region is technically feasible and represents the treatment of choice...

..We investigated known collagen-interacting proteins to further characterize connective tissue in these patients...

..The new technique of three-dimensional stereography makes it possible to describe and calculate the mobility of the abdominal wall and the nature of the underlying disturbances...

..Further studies must focus on the complex interactions of several extracellular matrix components...

..Complications of nerve damage, however, should be recognised, especially when extending the incision too far laterally...

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..The implantation of the long-term absorbable LTS-mesh seems to be favourable with respect to its long-term mechanical stability and the decreased connective tissue formation...

..Patients at risk should preoperatively be identified in order to improve treatment by, for example, the application of mesh techniques...

..To provide a review of existing literature on pediatric GIST with focus on clinical presentation...

..With regard to the quite similar polymer surface the pore size appears to be of major importance in tissue reaction and for the biocompatibility of mesh structures...

..Extended incisional hernia is inevitable when fascial closure is missed (up to 90% of cases). Intra-abdominal pressure (IAP) has not yet been evaluated as a criterion for the feasibility of fascial closure...

..An altered matrix composition as potential underlying pathology for the development of colorectal cancer was hypothesized...

..This applies to at least 10% of recurrences. Needed is a therapeutic algorithm for the surgical management of recurrent hernias after previous mesh repair...

..As the endoscopic technique has, nowadays, become routinely applied for diverse abdominal diseases worldwide, we present a review of literature facing its impact on collagen biology...

..Preparation must take into account the special anatomic features of the abdominal wall, especially in the area of the Linea alba and Linea semilunaris...

..In vivo, the adherence of bacteria to the implant material depends on the surface area, which favors the use of monofilament materials...

..Only with the last technique of abdominal wall reinforcement it is possible to achieve a recurrence rate of under 20%. The best type of mesh and the optimal implantation technique are still under discussion...

..Open mesh repair, particularly with modern low-weight polypropylene meshes applied by the retromuscular underlay technique, offers excellent results in the treatment of incision hernias, even in long-term follow-up studies...

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..To investigate whether these differences in biomechanical properties influence collagen synthesis in the incisional region, an animal experiment on laparotomy closure was performed...

..The aim was to study the long-term tissue response to polypropylene mesh...

..This includes the hernia classification, the number of previous operations and the possibility of a defect in collagen metabolism. The unknown long-term risks for the patient may be taken only in strong indications...

..Incisional hernia formation is one of the most frequent complications in visceral surgery requiring reoperation. Risk factors for incisional hernia formation and preventive strategies are not clearly defined...

..In conclusion, these data confirm the improved biocompatibility of material-reduced mesh implants...

..Because directly comparing data are rare, this retrospective study evaluates the coincidence of neoplastic lesions and diverticular disease...

..Preliminary results indicate the presence of a risk population with collagen metabolism disturbances that have a major effect on wound healing after gastrointestinal anastomosis...

..This is complicated when cartilaginous or osseous structures border the fascial defect, most notably at the xiphoid after sternotomy or in large proximal incisional hernias...

..Knowledge of the anatomy and preparation of the "fatty triangle" enables a mesh positioning according to the principles of retromuscular mesh repair...

..New aspects of pharmacotherapy and better understanding of collagen synthesis and dynamics of closure tension might improve the clinical situation in the future...

..This study was aimed to reconstitute the esophageal wall and to investigate the functional and histological consequences of a new, non-absorbable polyvinylidene fluoride (PVDF) mesh and an absorbable polyglactin 910 (Vicryl((R))) mesh...

..Patients need competent guides to process surgical information from the Internet. The establishment of specialised institutions to control surgical Web sites according to quality, content, and legality on the European level is urgent...

..The Internet offers an increasing amount of medical information, but its value for surgical patients is doubtful...