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Fixation of Light Weight Polypropylene Mesh with n-Butyl-2-cyanocrylate in Pelvic Floor Surgery: Experimental Design Approach in Sheep for Effectiveness Evaluation.

Barbosa S, Nieves T, García F, Cepeda E, Moll X, Marco A, Weis C, Turon P, Vergara P - Biomed Res Int (2015)

Bottom Line: In all cases a clinical evaluation of the animal was performed.A reduction in the mesh size (Synthetic PP Mesh-1) together with precise application of the surgical glue Histoacryl to fix the mesh yielded significantly better histocompatibility results (P < 0.01) compared to larger size or other fixation methods.The combination of Synthetic PP Mesh-1 with Histoacryl offered a high degree of graft integration without vaginal ulceration and a minimal foreign body reaction, being the sheep a proper animal model to test these types of medical devices.

View Article: PubMed Central - PubMed

Affiliation: Department of Cell Biology, Physiology and Immunology, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, 08153 Barcelona, Spain ; Integrated Services of Laboratory Animals, Universitat Autònoma de Barcelona, Bellaterra, 08153 Barcelona, Spain.

ABSTRACT

Objective: The aim of this study was to find a proper experimental design and to evaluate n-butyl-2-cyanoacrylate (Histoacryl) as a fixation method for a light-weight and large pore PP mesh (Synthetic PP Mesh-1) using the sheep as an animal model.

Methods: Posterior vaginal implantation by means of episiotomy was used to implant 8 ewes which were evaluated macroscopically and histologically at 3 months (n = 4) and 6 months (n = 4) post-surgery. In previous pilot studies anterior vaginal implantation was evaluated, as well as different synthetic mesh materials, sizes and fixation methods (n = 1 to 3) during three weeks. In all cases a clinical evaluation of the animal was performed.

Results: A reduction in the mesh size (Synthetic PP Mesh-1) together with precise application of the surgical glue Histoacryl to fix the mesh yielded significantly better histocompatibility results (P < 0.01) compared to larger size or other fixation methods.

Conclusion: The combination of Synthetic PP Mesh-1 with Histoacryl offered a high degree of graft integration without vaginal ulceration and a minimal foreign body reaction, being the sheep a proper animal model to test these types of medical devices.

No MeSH data available.


Related in: MedlinePlus

Photographs showing some of the macroscopic findings described during tissue trimming. (a) PP-1-Hist-6 month group. Note the good position of the mesh despite the slight folding in one of the corners, which was the unique macroscopic finding observed in this group. (b) PP-1-Hist posterior 3 wk group. Note the complete folding of the mesh with exposure of the mesh into the vaginal cavity (dashed arrow) and into the colonic cavity (continuous arrow). (c) PP-2-PP posterior. Abscess associated to one of the polypropylene stitches. (d) PP-1-PP anterior 3 wk. Extrusion of the mesh into the vagina.
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fig2: Photographs showing some of the macroscopic findings described during tissue trimming. (a) PP-1-Hist-6 month group. Note the good position of the mesh despite the slight folding in one of the corners, which was the unique macroscopic finding observed in this group. (b) PP-1-Hist posterior 3 wk group. Note the complete folding of the mesh with exposure of the mesh into the vaginal cavity (dashed arrow) and into the colonic cavity (continuous arrow). (c) PP-2-PP posterior. Abscess associated to one of the polypropylene stitches. (d) PP-1-PP anterior 3 wk. Extrusion of the mesh into the vagina.

Mentions: The main macroscopic findings are shown in Table 3 and Figure 2. Overall, the two groups belonging to the main study with Synthetic PP Mesh-1 in combination with device applied Histoacryl displayed less mesh exposures, mesh folding, and abscesses. There was only one animal in which the mesh was partially folded in one corner, without causing further complications (Figure 2(a)).


Fixation of Light Weight Polypropylene Mesh with n-Butyl-2-cyanocrylate in Pelvic Floor Surgery: Experimental Design Approach in Sheep for Effectiveness Evaluation.

Barbosa S, Nieves T, García F, Cepeda E, Moll X, Marco A, Weis C, Turon P, Vergara P - Biomed Res Int (2015)

Photographs showing some of the macroscopic findings described during tissue trimming. (a) PP-1-Hist-6 month group. Note the good position of the mesh despite the slight folding in one of the corners, which was the unique macroscopic finding observed in this group. (b) PP-1-Hist posterior 3 wk group. Note the complete folding of the mesh with exposure of the mesh into the vaginal cavity (dashed arrow) and into the colonic cavity (continuous arrow). (c) PP-2-PP posterior. Abscess associated to one of the polypropylene stitches. (d) PP-1-PP anterior 3 wk. Extrusion of the mesh into the vagina.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4499369&req=5

fig2: Photographs showing some of the macroscopic findings described during tissue trimming. (a) PP-1-Hist-6 month group. Note the good position of the mesh despite the slight folding in one of the corners, which was the unique macroscopic finding observed in this group. (b) PP-1-Hist posterior 3 wk group. Note the complete folding of the mesh with exposure of the mesh into the vaginal cavity (dashed arrow) and into the colonic cavity (continuous arrow). (c) PP-2-PP posterior. Abscess associated to one of the polypropylene stitches. (d) PP-1-PP anterior 3 wk. Extrusion of the mesh into the vagina.
Mentions: The main macroscopic findings are shown in Table 3 and Figure 2. Overall, the two groups belonging to the main study with Synthetic PP Mesh-1 in combination with device applied Histoacryl displayed less mesh exposures, mesh folding, and abscesses. There was only one animal in which the mesh was partially folded in one corner, without causing further complications (Figure 2(a)).

Bottom Line: In all cases a clinical evaluation of the animal was performed.A reduction in the mesh size (Synthetic PP Mesh-1) together with precise application of the surgical glue Histoacryl to fix the mesh yielded significantly better histocompatibility results (P < 0.01) compared to larger size or other fixation methods.The combination of Synthetic PP Mesh-1 with Histoacryl offered a high degree of graft integration without vaginal ulceration and a minimal foreign body reaction, being the sheep a proper animal model to test these types of medical devices.

View Article: PubMed Central - PubMed

Affiliation: Department of Cell Biology, Physiology and Immunology, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, 08153 Barcelona, Spain ; Integrated Services of Laboratory Animals, Universitat Autònoma de Barcelona, Bellaterra, 08153 Barcelona, Spain.

ABSTRACT

Objective: The aim of this study was to find a proper experimental design and to evaluate n-butyl-2-cyanoacrylate (Histoacryl) as a fixation method for a light-weight and large pore PP mesh (Synthetic PP Mesh-1) using the sheep as an animal model.

Methods: Posterior vaginal implantation by means of episiotomy was used to implant 8 ewes which were evaluated macroscopically and histologically at 3 months (n = 4) and 6 months (n = 4) post-surgery. In previous pilot studies anterior vaginal implantation was evaluated, as well as different synthetic mesh materials, sizes and fixation methods (n = 1 to 3) during three weeks. In all cases a clinical evaluation of the animal was performed.

Results: A reduction in the mesh size (Synthetic PP Mesh-1) together with precise application of the surgical glue Histoacryl to fix the mesh yielded significantly better histocompatibility results (P < 0.01) compared to larger size or other fixation methods.

Conclusion: The combination of Synthetic PP Mesh-1 with Histoacryl offered a high degree of graft integration without vaginal ulceration and a minimal foreign body reaction, being the sheep a proper animal model to test these types of medical devices.

No MeSH data available.


Related in: MedlinePlus