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Biology & Mesh in abdominal wall surgery

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Information about Biology & Mesh in abdominal wall surgery
Science-Technology

Published on March 8, 2009

Author: pierippo

Source: authorstream.com

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Slide 1: MATERIALS’ EVOLUTION IN HERNIA SURGERY Lightweight Meshes Dott. Pier Luigi Ipponi AZIENDA SANITARIA DI FIRENZE Nuovo Ospedale San Giovanni di Dio S.C. di Chirurgia Generale Direttore: Dott. P. Cappellini Historical Aspect in Groin Hernia Surgery : Historical Aspect in Groin Hernia Surgery Tensionless Era: Use of Foreign Material: Animal Tendon (Marcy, 1887) Fascia Lata (Kirschner, 1905) Metallic Material (1910) Synthetic Polimers: Nyloon (Melick, 1937), Ivalon, Silastic, Teflon Polyester & Polypropylene Meshes, e-PTFE Patch Historical Aspect in Groin Hernia Surgery : Historical Aspect in Groin Hernia Surgery Tensionless Era: Use of Synthetic Polimers: Tissutal Strenghtening BY MECHANIC RESISTANCE OF MATERIALS Tissutal Stabilization BY BIOLOGICAL COLONIZATION OF MATERIALS Elasticity & Flexibility SUPPORT CONTINUOS TISSUTAL DYNAMISM Handling & Shaping Wide Selection of Materials Slide 4: MESHES ELASTICITY Slide 5: MESHES TENSIL STRENGHT UltraPro UltraPro COMPARISION OF ABDOMINAL PRESSURE WITH MESH BURST STRENGHT : COMPARISION OF ABDOMINAL PRESSURE WITH MESH BURST STRENGHT 700 600 500 400 300 200 100 STANDING PAIN PRESSING VOMITING COUGHING JUMPING ULTRAPRO MESH 13 44 59 110 150 252 650 Pressure mmHg Measured after Absorption Withstands 2 times the maximum abdominal pressure CADILLAC ELDORADO 1959 V8 ENGINE 345 HP (253.9 KW) - WEIGHT 5058 lbs 2294 Kg : CADILLAC ELDORADO 1959 V8 ENGINE 345 HP (253.9 KW) - WEIGHT 5058 lbs 2294 Kg AUDI A8 FSI 2008 V8 ENGINE 350 Hp (257Kw) - Weight 3944 lbs (1789 Kg) : AUDI A8 FSI 2008 V8 ENGINE 350 Hp (257Kw) - Weight 3944 lbs (1789 Kg) WOUND HEALING : WOUND HEALING SCAR TISSUE HEMORRHAGIA COMPLEMENT FORMATION PLATELET AGGREGATION & DEGRANULATION HEMOSTASIS IMMIGRATION OF CELLS REMOVAL OF CELLULAR DEBRIS INFECT RESISTANCE CELL ACTIVATION SECRECTION OF GROWTH FACTOR NEOVASCULARISATION CELL PROLIFERATION REEPITHELIZATION GRANULATION FORMATION OF NEW TISSUE WOUND CLOSURE FORMATION OF EXTRACELLULAR MATRIX TISSUE REMODELLING CYTOKINES 0-3 DAYS 3-12 DAYS 3 DAYS 6 MONTHS WOUND HEALING & MESH : WOUND HEALING & MESH MESH PORE SIZE & WEIGHT INFLAMATORY REACTION SURGICAL TRAUMA ACUTE CRONIC TISSUTAL TURN-OVER & REMODELLING SHRINKAGE DISCOMFORT “CRONIC WOUND” RECURRENCE Slide 11: FOREIGN BODY REACTION VS MESH:Cellular Proliferation - “Cronic Wound“ Cellular Proliferation (Ki 67) vs Inflamatory reaction and weight P.P. Slide 12: INCORPORATES THE 3 MOST IMPORTANT BENEFITS OF LIGHTWEIGT MESH DESIGN: THIN FILAMENT SIZE LARGE PORE CONSTRUCTION ABSORBABLE COMPONENTS ULTRA PRO PLUGTECHNICAL DATA : ULTRA PRO PLUGTECHNICAL DATA ULTRAPRO PLUG FEATURELightweight Construction : ULTRAPRO PLUG FEATURELightweight Construction STRONG: Partially Absorbable Lightweight Mesh, burst strength is more than 2 times stronger than the maximum abdominal pressure2,3 FLEXIBLE: Excellent tissue in-growth and wound healing enables a flexible, compliant scar3 COMFORTABLE: Flexible scar is compliant with abdominal wall3 2.Holste JL. Are meshes with lightweight construction strong enough? Int Surg. 2005;90(suppl 3);S10-S12. 3.Cobb WS, Kercher KW, Heniford BT. The argument for lightweight polypropylene mesh in hernia repair. Surg Innov. 2005;12:T1-T7. ULTRAPRO PLUG BENEFITPartially Absorbable Material : ULTRAPRO PLUG BENEFITPartially Absorbable Material Spacer fabric construction provides soft intraoperative feel for placement and excellent handling Constructed of nonabsorbable PROLENE? (Polypropylene) and absorbable MONOCRYL? (Poliglecaprone 25) filaments The MONOCRYL? component is essentially absorbed in approximately 4 months Only the lightweight polypropylene mesh remains after healing POLYHPROPYLENE PLUG : POLYHPROPYLENE PLUG PLUG FISTOLIZZATO : PLUG FISTOLIZZATO

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