聚丙烯单丝线植入式重睑术

目的：介绍一种新型材料（聚丙烯单丝线）植入式重睑术。方法：按上睑长度设计重睑线，从内到外标记出6点，即A、B、C、D、E、F点。重睑宽度按6～8mm设计。用带针聚丙烯单丝线从A点穿入，B点穿出，再从B点穿入C点穿出，直至穿出F点。将A、F点余线轻提剪除，使线头埋入皮下。结果：施术208例，其中184例形态良好；16例术后1月也恢复良好：8例内、外眦部重睑线消失，需再次手术。结论：聚丙烯单丝线植入式重睑术方法简单，操作方便快速，损伤小，肿胀轻微，恢复快，受术者容易接受。     

The Development of Equipment to Measure Mesh Erosion of Soft Tissue

Mesh erosion is a phenomenon whereby soft tissue becomes damaged as a result of contact with implants made from surgical mesh, a fabric-like material consisting of fibers of polypropylene or other polymers. This paper describes the design and construction of a testing machine to generate mesh erosion in vitro. A sample of mesh in the form of a 10 mm wide tape is pressed against soft tissue (porcine muscle) with a given force, and a given reciprocating movement is applied between the mesh and the tissue. To demonstrate the capabilities of the equipment, we measured erosion using the same mesh and tissue type, varying the applied force and the reciprocating stroke length, including zero strokes (i.e., static loading). For comparison, we also tested four other samples of polypropylene with different edge characteristics. Analysis of the results suggests the existence of three different erosion mechanisms: cutting, wear and creep. It is concluded that the equipment provides a useful and realistic simulation of mesh erosion, a phenomenon that is of great clinical significance and merits further study.     

Impact of demographic and perioperative risk factors on complication rates in skin-sparing/nipple-sparing mastectomy with implant-based reconstruction using titanized polypropylene mesh (TiLOOP® Bra)

BackgroundSkin/nipple-sparing mastectomies (SSM/NSSM) have been reported to have acceptable complication rates and good aesthetic outcomes with high patient satisfaction.However, in this relatively young and rapidly expanding field of reconstructive plastic surgery, differences in perioperative management are noted between breast centers. Prospective studies of complication rates using a titanized polypropylene mesh (TiLOOP® Bra) are currently lacking.MethodsA prospective subgroup analysis was performed based on the data set of the prospective, single-arm, multicenter observational study (PRO-BRA). Early complication rates after skin/nipple-sparing mastectomy with implant-based immediate or secondary reconstruction using a titanized polypropylene mesh (TiLOOP® Bra) subpectorally were investigated in relation to demographic factors, as well as intra-and postoperative management. The subgroup consists of 258 patients. Complications were categorised into necrosis, infection, postoperative bleeding or hematoma, seroma, wound healing delays and R1-situations.ResultsEarly complication rates of SSM/NSSM using titanium-based meshes are comparable to complication-rates using ADM's. Logistic regression shows significantly higher risk for wound healing delays, necrosis and seroma with increasing BMI, abladat- and implant-weight (OR 1,17 -1,66, p-value < 0,001). Smokers have significantly higher necrosis rates (20.7%) compared to non-smokers (5.5%) (p-value = 0.002). Discharge with drainage results in a trend toward higher rates of wound healing complications.ConclusionThe use of TiLOOP® Bra meshes was shown to have acceptable complication rates. Complication rates depend on certain demographic and intraoperative risk factors and should be considered in indications and information of patients.     

Influence of the β− Radiation/Cold Atmospheric-Pressure Plasma Surface Modification on the Adhesive Bonding of Polyolefins

The goal of this research was to examine the effect of two surface modification methods, i.e., radiation cross-linking and plasma treatment, on the adhesive properties and the final quality of adhesive bonds of polypropylene (PP), which was chosen as the representative of the polyolefin group. Polymer cross-linking was induced by beta (accelerated electrons—β⁻) radiation in the following dosages: 33, 66, and 99 kGy. In order to determine the usability of β⁻ radiation for these applications (improving the adhesive properties and adhesiveness of surface layers), the obtained results were compared with values measured on surfaces treated by cold atmospheric-pressure plasma with outputs 2.4, 4, and 8 W. The effects of both methods were compared by several parameters, namely wetting contact angles, free surface energy, and overall strength of adhesive bonds. Furthermore, Fourier transform infrared (FTIR) spectroscopy and scanning electron microscopy (SEM) were conducted. According to our findings the following conclusion was reached; both tested surface modification methods significantly altered the properties of the specimen’s surface layer, which led to improved wetting, free surface energy, and bond adhesion. Following the β⁻ radiation, the free surface energy of PP rose by 80%, while the strength of the bond grew in some cases by 290% in comparison with the non-treated surface. These results show that when compared with cold plasma treatment the beta radiation appears to be an effective tool capable of improving the adhesive properties and adhesiveness of PP surface layers.     

Effect of alpha lipoic acid co‐administration on structural and immunohistochemical changes in subcutaneous tissue of anterior abdominal wall of adult male albino rat in response to polypropylene mesh implantation

Polypropylene mesh is commonly used in the treatment of abdominal hernia. Different approaches were addressed to improve their tissue integration and consequently reduce long‐term complications. This study aimed to investigate the effect of alpha‐lipoic acid (ALA) co‐administration on structural and immunohistochemical (IHC) changes in the subcutaneous tissues of the anterior abdominal wall of the adult rat in response to polypropylene mesh implantation. Forty adult male albino rats were divided into: group I (control), group II (receiving ALA), group III (polypropylene mesh implantation) and group IV (mesh implantation + ALA co‐administration). After 4 weeks, subcutaneous tissue samples were prepared for light microscopy and IHC study of CD34 as a marker for angiogenesis. In groups I and II rats, positive CD34 expression was demonstrated by IHC reaction, localized to endothelial cells lining small blood vessels. Group III showed an excess inflammatory reaction, deposition of both regular and irregularly arranged collagen fibres around mesh pores and few elastic fibres. CD34‐positive was detected not only in cells lining small blood vessels but also in other cells scattered in the connective tissue indicating angiogenesis. In group IV, ALA co‐administration resulted in less inflammatory reaction, regular collagen deposition, enhanced elastic fibres synthesis and a significant increase in CD34‐positive cells and small blood vessels reflecting improved angiogenesis. ALA co‐administration with polypropylene mesh implantation controlled the inflammatory reaction, helped regular collagen deposition, enhanced elastic fibres synthesis and improved angiogenesis in the subcutaneous tissue of anterior abdominal wall of adult albino rats, suggesting a possible role of ALA in optimizing mesh integration in subcutaneous tissue.     

Follow-up after polypropylene mesh repair of anterior and posterior compartments in patients with recurrent prolapse

To retrospectively analyze the outcome of surgery in women followed up for 1 year after vaginal repair with the Apogee® (support of posterior vaginal wall) or Perigee® (support of anterior vaginal wall) system. A total of 120 patients with recurrent cystocele and/or rectocele or with combined vaginal vault prolapse were treated by either posterior or anterior mesh interposition depending on the defect. Follow-up after 1 year (±31 days) comprised a vaginal examination with prolapse grading using the POP-Q system, measurement of vaginal length, evaluation of the vaginal mucosa, and exploration for mesh erosions. Postoperatively, 112 (93%) women were free of vaginal prolapse, whereas 8 (7%) had level 2 defects. Erosions occurred significantly more often (p?=?0.042) in patients treated with the Perigee system. Our results suggest that the Apogee® and Perigee® repair systems (monofilament polypropylene mesh) yield excellent short-term results after 1 year.     

Interposition of polyglactin mesh does not prevent adhesion formation between viscera and polypropylene mesh

BACKGROUND: The use of intra-peritoneal polypropylene mesh (PPM) to repair incisional hernia carries the risk of adhesions and damage to the intra-abdominal viscera. Polyglactin 910 mesh (PGM) is advocated to avoid contact between PPM and the intra-abdominal viscera. An experimental study in rats was performed to determine if interposition of a resorbable prosthesis between the PPM and viscera alters biocompatibility, adhesion formation, and herniation. MATERIALS AND METHODS: A 2- x 3-cm abdominal wall defect was created in 80 rats. Rats were randomly assigned for repair with 2.5- x 3.5-cm PPM (n = 40) or 2.5- x 3.5-cm PPM plus polyglactin 910 mesh (PPM-PGM) (n = 40). The rats were sacrificed at 1, 2, 3, and 6 months (n = 10), and an autopsy was performed to determine herniation and adhesion rates. Mesh-fascia interface was taken for histology. RESULTS: In the PPM group, 1 rat died before the end of the experiment, and at 6 months one of the 10 rats had a herniation. In the PPM-PGM group, two rats died before the end of the experiment, and two rats had a herniation after 1 month and three rats after 6 months. At 1, 2, and 3 months the adhesion score in the PPM group (median, 3; range, 2-3) did not differ from the score in the PPM-PGM group (median, 3; range, 2-3). Also, at 6 months the adhesion score in the PPM group (median, 2; range, 2-3) did not differ from the score in the PPM-PGM group (median, 3; range, 2-3). At microscopy a capsule was formed around the PP fibers, which matured over months in the PPM group. In the first month after implantation an inflammatory response was seen. Histology was similar in both groups, although in the early PPM-PGM group the inflammatory response was more evident. CONCLUSION: Interposition of PGM between PPM and viscera does not alter adhesion formation nor influences herniation rate.     

Use of Triple-Convergence Polypropylene Thread™ for the Aesthetic Correction of Partial Facial Paralysis

Rehabilitation and reanimation of the paralyzed face remains a challenge. A variety of autografts and allografts have been used for static facial suspension. We report two cases of long-standing partial facial paralysis treated with 3C triple-convergence polypropylene thread. A 39-year-old woman with right-sided partial facial paralysis underwent an endoscopy-assisted facial suspension using the 3C threads and a 60-year-old woman with right-sided partial facial paralysis underwent a round face-lifting combined with endoscopic brow lift and placement of 3C triple-convergence polypropylene threads. Its use for partial facial paralysis has not been previously described. The 1-year follow-up shows effective preservation of the surgical result and patient satisfaction.