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- ItemSomente MetadadadosEarly and late postoperative inflammatory and collagen deposition responses in three different meshes: an experimental study in rats(Springer, 2014-08-01) Pereira-lucena, C. G. [UNIFESP]; Artigiani Neto, R. [UNIFESP]; Rezende, D. T. de [UNIFESP]; Lopes-Filho, G. de J. [UNIFESP]; Matos, D. [UNIFESP]; Linhares, M. M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Although meshes reduce abdominal hernia recurrence, they increase the risk of inflammatory complications. This study aimed to compare the early and late postoperative inflammation and collagen deposition responses induced by three meshes.Rats were allocated into three groups. in group I, a polypropylene (PP) mesh was implanted in the abdominal wall. in groups II and III, PP + polyglactin (PP + PG) and PP + titanium (PP + TI) meshes were employed, respectively. On the seventh (7th) postoperative day, collagen deposition and inflammation were evaluated, and immunohistochemistry was performed on abdominal wall biopsies. These data were compared with those obtained on the fortieth (40th) postoperative day in a previous study.The early inflammatory responses were the same in all groups. With time, it decreased in group I (p = 0.047) and increased in group II (p = 0.003). Group I exhibited early elevated VEGF (p < 0.001), COX2 (p < 0.001), and collagen (p = 0.023) levels, and group II exhibited the most severe inflammatory tissue response. On the 40th postoperative day, the VEGF (p < 0.001) and collagen (p < 0.005) were reduced as compared with the 7th postoperative day in all groups.Belatedly, the inflammatory reaction decreased in PP mesh group and increased in PP + PG mesh group. the PP mesh induced early great elevations in VEGF, COX2 and collagen levels, whereas the PP + PG mesh caused severe tissue inflammation with small elevation in these levels. PP + TI mesh induced inflammatory response levels between the others. in conclusion, the inflammatory response depends on the mesh density and also the mesh material with clinical implications.
- ItemSomente MetadadadosExperimental study comparing meshes made of polypropylene, polypropylene plus polyglactin and polypropylene plus titanium: inflammatory cytokines, histological changes and morphometric analysis of collagen(Springer, 2010-06-01) Pereira-Lucena, C. G. [UNIFESP]; Artigiani-Neto, R. [UNIFESP]; Lopes-Filho, G. J. [UNIFESP]; Frazao, C. V. G. [UNIFESP]; Goldenberg, A. [UNIFESP]; Matos, D. [UNIFESP]; Linhares, M. M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Incisional hernia occurs in approximately 11% of all laparotomies. Changes in collagen have been closely implicated in its pathogenesis. the high recurrence rate (45-54%) after primary suture has stimulated the development of meshes. Currently, meshes are the biomaterials implant group most used in medicine. This study aims to compare the serum and tissue inflammatory responses and collagen deposition caused by meshes made of polypropylene, polypropylene + polyglactin and polypropylene + titanium.Thirty Wistar rats were divided into three groups. in group I, a high-density polypropylene mesh was positioned on the abdominal wall. in groups II and III, low-density meshes were used in associations with polyglactin and titanium, respectively. Immediately before the operation and on the first, third and fortieth postoperative days, pro-inflammatory cytokines were assayed. On the 40th postoperative day, the region of the inserted prosthesis was biopsied. the tissue inflammatory reaction was evaluated using a scale for objective scoring. for collagen, picrosirius was used with data reading using the Image Tool computer software.Cytokines: there were no statistically significant differences between the groups. Histology: on the 40th postoperative day in group I, there were fewer inflammatory tissue response and greater collagen deposition (P < 0.01). in group II, there were greater inflammatory tissue response and less collagen deposition (P < 0.01). Group III presented intermediate values between groups I and II.There were no significant differences in cytokine levels between the groups in the present study. in the animals with the polypropylene + polyglactin mesh implant there was the most intense inflammatory process with lower tissue maturation and collagen deposition on the 40th postoperative day. the polypropylene mesh presented a less severe late inflammatory process, with greater tissue maturation and collagen deposition. the polypropylene + titanium mesh presented intermediate values between the others.
- ItemAcesso aberto (Open Access)Malhas para prevenção de lesões por pressão nas regiões de proeminências ósseas do quadril – revisão sistematizada de literatura(Universidade Federal de São Paulo (UNIFESP), 2020-11-17) Severiano, Eneas Jose Figueiredo [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São PauloIntroduction: The pressure injuries result from the continuous pressure exertec by bony pcoeminences in the tegument pressed against a surface. Apparatus and devices have beem proposed in na attempt do mitigate the pressure in these áreas, mosf of which are highly complex and costly, which makes it difficult to adhere to treatment, especially after hospital discharge. Objective: To perform a literature review and search for anteriority on meshes or clothing to prevent pressure injuires in the regions of bony proeminences of the hip. Method: The search covered from April 1988 to July 2020. It was carried on the databases (Cochrane Library, Lilacs, Scielo, Medline, Web of Science & SSOPUS), having as inclusion criteria clothing aimed at preventing pressure injuries in the region of bone proeminences of the hip; there was no criteria of non-inclusion. The search of anteriority was made in the patent databases: LATIPAT (Espace Patent Search), Google Patent Search, USPTO (United States Patent and Tradmark Office), WiPO (Wordl Intellectual Property Organization), JPO (Japan Property Office, CNIPA (National Intellectual Property Agency – China) and INPI – e-patents (National Intellectual Property Institute. Results: two garments were found in the patent bases. Conclusion: No results were found for searches with the Keywords “prevention”, “injury”, “pressure”, “clothing”, “mesh” and related terms in the scientific literature. Two garments were found in the patent bases.
- ItemAcesso aberto (Open Access)The role of bovine preserved peritoneum in rats ventral hernia: a histological evaluation(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2006-10-01) Bastos, Eduardo Lemos de Souza; Fagundes, Djalma José [UNIFESP]; Taha, Murched Omar [UNIFESP]; Novo, Neil Ferreira [UNIFESP]; Juliano, Yara [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Silvado, Rubens Augusto Brazil [UNIFESP]; Marilia Medicine School Department of Surgery; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To assess the role of preserved bovine parietal peritoneum as a material for hernia repair in a rat ventral hernia model. METHODS: An abdominal wall defect (15mm x 25mm) was created in Wistar male rats (n=40). Control animals (n=20) had the polypropylene (PP) mesh sutured into the defect, whereas bovine preserved peritoneum (BPP) was used in experimental group (n=20). After 7 and 28 days, the abdominal wall was taken off and histological studies of the amount of collagen by Sirius Red stain and morphometric evaluation consisted in quantitative analysis of the collagen by using specific software (Imagelab®). The Mann-Whitney, Kruskal-Wallis and ANOVA tests were applied for statistical analysis (pd0.05). RESULTS: Histological examination revealed no difference between the BPP and PP groups (p = 0.55 NS). CONCLUSION: BPP is suitable for the closure of ventral hernias in rat model as shown by its morphological properties.
- ItemSomente MetadadadosShrinkage evaluation of heavyweight and lightweight polypropylene meshes in inguinal hernia repair: a randomized controlled trial(Springer, 2011-12-01) Silvestre, A. C.; Mathia, G. B. de; Fagundes, D. J. [UNIFESP]; Medeiros, L. R.; Rosa, M. I.; Univ Extremo Sul Catarinense; Universidade Federal de São Paulo (UNIFESP); Univ Fed Rio Grande do SulOne of the current complications in inguinal repair is shrinkage following the use of mesh. the selected mesh material, heavyweight (HWM) mesh or lightweight (LWM) mesh, is associated with the frequency of shrinkage. the aim of this study was to investigate shrinkage of these two types of mesh in a controlled trial of male inguinal hernia repair.Thirty-two healthy men with primary unilateral inguinal hernias (Nyhus classification), who presented at So Jos, Hospital of CriciA(0)ma, Brazil, underwent the Lichtenstein procedure. in total, 16 polypropylene HWM (105 g/m(2)) and 16 partially absorbable LWM (28 g/m(2)) were implanted into randomly selected patients. On post-operative days 1, 30, 60 and 90, the area of the mesh was evaluated by digital radiography.The study randomized 32 patients and analyzed 30 patients-15 for each type of mesh. At baseline, there were no differences between groups. There were significant differences between the two meshes when comparing the total area initially and on postoperative day 90 (P = 0.001). the HWM had significantly less area initial area, as compared with 90 days postoperatively (P = 0.04).Shrinkage was significantly higher for HWM, although the difference was not large.
- ItemAcesso aberto (Open Access)The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial(Springer, 2013-11-01) Delroy, Carlos Antonio [UNIFESP]; Castro, Rodrigo de Aquino [UNIFESP]; Dias, Marcia M. [UNIFESP]; Feldner Junior, Paulo Cezar [UNIFESP]; Bortolini, Maria Augusta Tezelli [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The aim of the study was to compare the efficacy and safety of transvaginal trocar-guided polypropylene mesh insertion with traditional colporrhaphy for treatment of anterior vaginal wall prolapse.This is a randomized controlled trial in which women with advanced anterior vaginal wall prolapse, at least stage II with Ba a parts per thousand yenaEuro parts per thousand+1 cm according to the Pelvic Organ Prolapse Quantification (POP-Q) classification, were randomly assigned to have either anterior colporrhaphy (n = 39) or repair using trocar-guided transvaginal mesh (n = 40). the primary outcome was objective cure rate of the anterior compartment (point Ba) assessed at the 12-month follow-up visit, with stages 0 and I defined as anatomical success. Secondary outcomes included quantification of other vaginal compartments (POP-Q points), comparison of quality of life by the prolapse quality of life (P-QOL) questionnaire, and complication rate between the groups after 1 year. Study power was fixed as 80 % with 5 % cutoff point (p < 0.05) for statistical significance.The groups were similar regarding demographic and clinical preoperative parameters. Anatomical success rates for colporrhaphy and repair with mesh placement groups were 56.4 vs 82.5 % (95 % confidence interval 0.068-0.54), respectively, and the difference between the groups was statistically significant (p = 0.018). Similar total complication rates were observed in both groups, with tape exposure observed in 5 % of the patients. There was a significant improvement in all P-QOL domains as a result of both procedures (p < 0.001), but they were not distinct between groups (p > 0.05).Trocar-guided transvaginal synthetic mesh for advanced anterior POP repair is associated with a higher anatomical success rate for the anterior compartment compared with traditional colporrhaphy. Quality of life equally improved after both techniques. However, the trial failed to detect differences in P-QOL scores and complication rates between the groups.