Biomechanical and Histologic Evaluation of LifeMesh™: A Novel Self-Fixating Mesh Adhesive

2018 ◽  
Vol 84 (4) ◽  
pp. 520-525 ◽  
Author(s):  
Charles P. Shahan ◽  
Nathaniel N. Stoikes ◽  
Esra Roan ◽  
James Tatum ◽  
David L. Webb ◽  
...  
Keyword(s):  
Polypropylene Mesh ◽  
Inflammatory Responses ◽  
Mesh Fixation ◽  
Interfacial Strength ◽  
Total Surface Area ◽  
Fixation Strength ◽  
Swine Model ◽  
Time Points ◽  
Lap Shear ◽  
Control Samples

Mesh fixation with the use of adhesives results in an immediate and total surface area adhesion of the mesh, removing the need for penetrating fixation points. The purpose of this study was to evaluate LifeMesh™, a prototype mesh adhesive technology which coats polypropylene mesh. The strength of the interface between mesh and tissue, inflammatory responses, and histology were measured at varying time points in a swine model, and these results were compared with sutures. Twenty Mongrel swine underwent implantation of LifeMesh™ and one piece of bare polypropylene mesh secured with suture (control). One additional piece of either LifeMesh™ or control was used for histopathologic evaluation. The implants were retrieved at 3, 7, and 14 days. Only 3- and 7-day specimens underwent lap shear testing. On Day 3, LifeMesh™ samples showed considerably less contraction than sutured samples. The interfacial strength of Day 3 LifeMesh™ samples was similar to that of sutured samples. At seven days, LifeMesh™ samples continued to show significantly less contraction than sutured samples. The strength of fixation at seven days was greater in the control samples. The histologic findings were similar in LifeMesh™ and control samples. LifeMesh™ showed significantly less contraction than sutured samples at all measured time points. Although fixation strength was similar at three days, the interfacial strength of LifeMesh™ remained unchanged, whereas sutured controls increased by day 7. With histologic equivalence, considerably less contraction, and similar early fixation strength, LifeMesh™ is a viable mesh fixation technology.

Biomechanical Comparison of Fibrin Sealants for Mesh Fixation

2018 ◽  
Vol 84 (5) ◽  
pp. 633-636
Author(s):  
Charles P. Shahan ◽  
Nathaniel F. Stoikes ◽  
Esra Roan ◽  
Patrick Reese ◽  
David L. Webb ◽  
...  
Keyword(s):  
Mesh Fixation ◽  
Early Recurrence ◽  
Fixation Strength ◽  
Spray Application ◽  
Lap Shear ◽  
Application Techniques ◽  
Tissue Interface ◽  
Application Methods ◽  
Biomechanical Comparison ◽  
Early Fixation

Adhesive use for fixation in hernia repair allows for complete and immediate mesh surface area adherence. Little is known about the fixation strengths of the products and application methods available. The purpose of this study was to compare the immediate and early strength of fixation of Tisseel™ and Evicel™ using hand and spray application techniques. Sixteen Mongrel swine underwent implantation of large-pore, mid-weight polypropylene mesh fixated with either Tisseel™ or Evicel™, applied by hand or with a spray apparatus. Time points studied were zero and four days. All samples underwent lap shear testing to quantify the strength of the mesh–tissue interface as an indicator of mesh fixation strength. Thirty Day 4 and 16 Day 0 samples were tested. Manually applied Tisseel™ mean fixation strength was 2.05 N/cm at Day 0 and 6.02 N/cm at Day 4. Sprayed Tisseel™ had mean fixation strength of 1.22 N/cm at Day 0 and 7.21 N/cm at Day 4. Manually applied Evicel™ showed mean fixation strength of 0.92 N/cm at Day 0 and 6.73 N/cm at Day 4. Mean fixation strength of sprayed Evicel™ was 0.72 N/cm at Day 0 and 6.70 N/cm at Day 4. Analysis of variance showed no difference between groups at Day 0 or Day 4. Immediate strength of mesh fixation could have significant implications for early recurrence and mesh contraction. This study demonstrates that no difference exists in immediate or early fixation strength between these two brands of sealants or their method of application.

scholarly journals P044 ATRAUMATIC AND CONSISTENT HERNIA MESH FIXATION: PERFORMANCE AND SAFETY IN A LAPAROSCOPIC IPOM PORCINE MODEL

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Miguel Lopes ◽  
Elisa Bitton ◽  
Elise Devries ◽  
Maria Pereira
Keyword(s):  
Histological Analysis ◽  
Porcine Model ◽  
Mesh Fixation ◽  
Fixation Strength ◽  
Tissue Ingrowth ◽  
Hernia Mesh ◽  
Local Tissue ◽  
Abdominal Adhesion ◽  
Mesh Shrinkage

Abstract Aim Demonstrate the performance and safety of TISSIUM on-demand activated adhesive for atraumatic hernia mesh fixation in a laparoscopic IPOM porcine model. Material and Methods Full thickness 4 cm in diameter excisional abdominal defects (n = 14) were created in pig (n = 8). The defects were repaired through laparoscopic intraperitoneal mesh placement using commercial composite meshes fixed with TISSIUM adhesive (n = 8) or resorbable tacks (n = 6). The animals were sacrificed after 28 and 90 days. An independent pathologist evaluated abdominal adhesion, mesh shrinkage, local tissue tolerance and tissue ingrowth through histological analysis (H&E and Movat Pentacrome) at sacrifice. Fixation strength of the explanted abdominal walls was also assessed via burst-ball. Results No adverse events were observed at implantation or during the survival period. All the meshes were in place at sacrifice. Mesh shrinkage and abdominal adhesion scores were similar between the two groups. Histological analysis of the mesh demonstrated equivalent quality of tissue ingrowth and excellent local tissue tolerance with minimal/mild foreign body response and mononuclear cells inflammation. The repair strength, evaluated through a burst ball method 90 days after implantation, showed no significant difference between the TISSIUM adhesive and tacks. Usability is currently being evaluated in clinically relevant models. Conclusions In this preclinical study the TISSIUM adhesive demonstrated similar fixation strength and quality of repair when compared to commercial tacks. This technology has the potential to impact hernia procedures standardization and reduce pain often associated with current fixation technologies.

scholarly journals P049 SAFETY AND EFFICACY OF ABSORBABLE AND NON-ABSORBABLE FIXATION SYSTEMS FOR INTRAPERITONEAL MESH FIXATION: AN EXPERIMENTAL STUDY IN SWINE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Spyridon Kapoulas ◽  
Apostolos Papalois ◽  
Georgios Papadakis ◽  
Georgios Tsoulfas ◽  
Emmanouil Christoforidis ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Mesh Fixation ◽  
Peel Strength ◽  
Swine Model ◽  
Abdominal Wall Defects ◽  
Hernia Surgery ◽  
Safety And Efficacy ◽  
Mesh Placement ◽  
Intraperitoneal Mesh ◽  
Mesh Shrinkage

Abstract Aim Choice of the best fixation system in terms of safety and effectiveness for intraperitoneal mesh placement in hernia surgery remains controversial. The aim of this study was to compare the performance of four fixation systems in a swine model of intraperitoneal mesh fixation. Material and Methods Fourteen Landrace swine were utilized and the experiment included two stages. Initially, four pieces of polypropylene mesh with hydrogel barrier coating1 were fixed intraperitoneally to reinforce 4 small full thickness abdominal wall defects created with diathermy. Each mesh was anchored with a different tack device between titanium2, steel3 or absorbable (4,5) fasteners. The second stage took place after 60 days and included euthanasia, laparoscopy, and laparotomy. The primary endpoint was to compare the peel strength of the compound tack/mesh from the abdominal wall. Secondary parameters were the extent and quality of visceral adhesions to the mesh, the degree of mesh shrinkage and the histological response around the tacks. Results Thirteen out of 14 animals survived the experiment and 10 were included in the final analysis. Steel tacks had higher peel strength when compared to titanium and absorbable fasteners. No significant differences were noted regarding the secondary endpoints. Conclusions Steel fasteners provided higher peel strength that the other devices in this swine model of intraperitoneal mesh fixation. Our findings generate the hypothesis that this type of fixation may be superior in a clinical setting. Clinical trials with long-term follow-up are required to assess the safety and efficacy of mesh fixation systems in hernia surgery.

scholarly journals Highly Sensitive Single Molecular Array Immunoassay Measurement of t-Tau, NF-L, GFAP, and UCH-L1 Biomarkers in Acute Concussion/Mild Traumatic Brain Injury (mTBI) Patient Serum and Saliva Samples

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S19.3-S20
Author(s):  
Ahmed Chenna ◽  
Christos Petropoulos ◽  
John Winslow
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Limited Information ◽  
Post Injury ◽  
Time Points ◽  
Highly Sensitive ◽  
Biomarker Analysis ◽  
T Tau ◽  
Control Samples

ObjectiveTo determine if t-Tau, NF-L, GFAP and UCH-L1 protein biomarkers are elevated in early time points of acute concussion/mild traumatic brain injury patient serum and saliva, relative to control samples.Backgroundt-Tau, NF-L, GFAP and UCH-L1 levels have been reported to increase in cerebral spinal fluid (CSF) and blood following head trauma within 24 hours or longer, and are candidate diagnostic and prognostic biomarkers of concussion and mild to moderate TBI. However, limited information exists on the relationship between these biomarkers at short time points post-injury, and detectability in saliva of mTBI patients.Design/MethodsBiomarker analysis of serum from a total of 120 participants, derived from two independent sample groups consisting of 60 concussion/mTBI patients each, with blood collected within 1-4 hr and 8-16 hr post-injury, respectively, was compared with 30 healthy control sera. Saliva samples were collected after 8-16 hr post-injury from a n = 30 subset of the same patients. Quanterix Simoa 4-plex immunoassay was used for highly sensitive measurements of these biomarkers.ResultsMedian levels of NF-L, GFAP and UCH-L1 were significantly higher in independent sets of patient serum samples (n = 60 each), both at early (1–4 hr) and later (8–16 hr) time points post-mTBI/concussion, relative to control samples (n = 30) (p < 0.0001, = 0.0001, <0.0001, respectively). Low levels of t-Tau are detected, but are significantly elevated post-concussion relative to controls (p = 0.0001). Significant correlations were observed between levels of t-Tau and UCH-L1, NF-L and GFAP, and t-Tau and GFAP in both post-injury time-point groups, and between NF-L and UCH-L1 levels in the 8-16 hr group. The four biomarkers were detected in saliva from concussion/mTBI patients (n = 30).ConclusionsThis study supports the utility of ultra-sensitive multiplex immunoassays to detect increases in CNS proteins at high sensitivity in serum and saliva within 1-4 and 8-16 hr of concussion/mTBI.

Lightweight polypropylene mesh fixation in laparoscopic incisional hernia repair

2013 ◽  
Vol 22 (5) ◽  
pp. 283-287 ◽  
Author(s):  
Giuseppe Cavallaro ◽  
Fabio Cesare Campanile ◽  
Mario Rizzello ◽  
Francesco Greco ◽  
Olga Iorio ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Polypropylene Mesh ◽  
Mesh Fixation ◽  
Incisional Hernia Repair ◽  
Laparoscopic Incisional Hernia Repair ◽  
Lightweight Polypropylene Mesh

scholarly journals Glycoproteoform Profiles of Individual Patients’ Plasma Alpha-1-Antichymotrypsin are Unique and Extensively Remodeled Following a Septic Episode

2021 ◽  
Vol 11 ◽  
Author(s):  
Tomislav Čaval ◽  
Yu-Hsien Lin ◽  
Meri Varkila ◽  
Karli R. Reiding ◽  
Marc J. M. Bonten ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Inflammatory Responses ◽  
Acute Phase Proteins ◽  
General Trend ◽  
Physiological State ◽  
Native Mass Spectrometry ◽  
Proof Of Concept ◽  
Time Points ◽  
Septic Episode ◽  
Sepsis And Septic Shock

Sepsis and septic shock remain the leading causes of death in intensive care units (ICUs), yet the pathogenesis originating from the inflammatory response during sepsis remains ambiguous. Acute-phase proteins are typically highly glycosylated, and the nature of the glycans have been linked to the incidence and severity of such inflammatory responses. To further build upon these findings we here monitored, the longitudinal changes in the plasma proteome and, in molecular detail, glycoproteoform profiles of alpha-1-antichymotrypsin (AACT) extracted from plasma of ten individual septic patients. For each patient we included four different time-points, including post-operative (before sepsis) and following discharge from the ICU. We isolated AACT from plasma depleted for albumin, IgG and serotransferrin and used high-resolution native mass spectrometry to qualitatively and quantitatively monitor the multifaceted glycan microheterogeneity of desialylated AACT, which allowed us to monitor how changes in the glycoproteoform profiles reflected the patient’s physiological state. Although we observed a general trend in the remodeling of the AACT glycoproteoform profiles, e.g. increased fucosylation and branching/LacNAc elongation, each patient exhibited unique features and responses, providing a resilient proof-of-concept for the importance of personalized longitudinal glycoproteoform profiling. Importantly, we observed that the AACT glycoproteoform changes induced by sepsis did not readily subside after discharge from ICU.

scholarly journals Biofilm-coated microbeads and the mouse ear skin: An innovative model for analysing anti-biofilm immune response in vivo

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243500
Author(s):  
Léo Sauvat ◽  
Aizat Iman Abdul Hamid ◽  
Christelle Blavignac ◽  
Jérôme Josse ◽  
Olivier Lesens ◽  
...  
Keyword(s):  
Real Time ◽  
Medical Devices ◽  
Immune Cells ◽  
Inflammatory Responses ◽  
Late Time ◽  
Average Cell ◽  
Time Points ◽  
Mouse Ear

Owing to its ability to form biofilms, Staphylococcus aureus is responsible for an increasing number of infections on implantable medical devices. The aim of this study was to develop a mouse model using microbeads coated with S. aureus biofilm to simulate such infections and to analyse the dynamics of anti-biofilm inflammatory responses by intravital imaging. Scanning electron microscopy and flow cytometry were used in vitro to study the ability of an mCherry fluorescent strain of S. aureus to coat silica microbeads. Biofilm-coated microbeads were then inoculated intradermally into the ear tissue of LysM-EGFP transgenic mice (EGFP fluorescent immune cells). General and specific real-time inflammatory responses were studied in ear tissue by confocal microscopy at early (4-6h) and late time points (after 24h) after injection. The displacement properties of immune cells were analysed. The responses were compared with those obtained in control mice injected with only microbeads. In vitro, our protocol was capable of generating reproducible inocula of biofilm-coated microbeads verified by labelling matrix components, observing biofilm ultrastructure and confirmed in vivo and in situ with a matrix specific fluorescent probe. In vivo, a major inflammatory response was observed in the mouse ear pinna at both time points. Real-time observations of cell recruitment at injection sites showed that immune cells had difficulty in accessing biofilm bacteria and highlighted areas of direct interaction. The average speed of cells was lower in infected mice compared to control mice and in tissue areas where direct contact between immune cells and bacteria was observed, the average cell velocity and linearity were decreased in comparison to cells in areas where no bacteria were visible. This model provides an innovative way to analyse specific immune responses against biofilm infections on medical devices. It paves the way for live evaluation of the effectiveness of immunomodulatory therapies combined with antibiotics.

Abstract T P324: Sex Differences in Ischemic Outcomes and Inflammatory Responses in Neonatal Stroke

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Mehwish A Mirza ◽  
Kathryn Bentivegna ◽  
Rodney Ritzel ◽  
Kaitlyn H Hajdarovic ◽  
Louise D McCullough ◽  
...  
Keyword(s):  
Sex Differences ◽  
Inflammatory Response ◽  
Microglial Activation ◽  
Inflammatory Responses ◽  
Tissue Injury ◽  
Activation Markers ◽  
Male And Female ◽  
Hormone Levels ◽  
Time Points ◽  
Cytokine Analysis

Background and Purpose: Neonatal arterial ischemic stroke (NAIS) is an important cause of motor and cognitive impairment in children. Clinically, male infants are more vulnerable to ischemic insult and suffer more long-term deficits than female infants though the mechanisms remain elusive. Inflammatory processes are fundamental in the pathophysiology of ischemia as microglial activation initiates the inflammatory response after ischemia. Recent studies report a sexual dimorphism in microglia numbers and expression of activation markers in neonatal brains under normal conditions. How these basal sex differences in microglia affect NAIS remains largely unexplored. This study investigated sex differences in stroke phenotypes and inflammation triggered by NAIS. We hypothesize that ischemia induces sex-specific tissue injury in male and female neonates, which is related to differences in microglial activation and inflammatory responses. Methods: Male and female C57BL6 mice were subjected to 60-minute Rice-Vanucci Modeling at post-natal day 10 (P10) to induce NAIS. Stroke outcomes were measured at 24 hours, 72 hours and 7 days after stroke. Microglial activation and inflammatory responses were evaluated by flow cytometry, immunohistochemistry, and multiplex cytokine analysis. Results: At 24 hours no difference in infarct volumes (total infarct: male vs. female 46.6±7.2% vs. 43.2±9.3%, n=6/gp) and in Iba-1 staining of the ischemic brain were seen between male and female neonates. However, at 72 hours female neonates exhibited significantly smaller infarct size and improved behavior outcomes compared to males (total infarct: male vs. female 43.1±9.9% vs. 27.1±8.8%, n=6/gp, p <.05). Male animals demonstrated increased microglial activation and up-regulated inflammatory response compared to females at 72 hours. This male-specific phenotype was also seen at 7 days after injury. There was no difference in hormone levels at any of the three time points after stroke. Conclusions: Acute ischemia leads to an equivalent primary brain injury in male and female P10 mice. However, infarct damage worsens in males at sub-acute time points vs. females, as does the immune response. This sex difference independent of hormone levels exists in NAIS.

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