Synthetic mesh placement - modality of choice in spontaneous intercostal pleural herniation: a case report

Hernia is defined as protrusion of a viscus or its part from the wall covering it and in some rare cases due to increased intercostal space there is spontaneous herniation of pleura and lung also known as extrathoracic lung hernia. A 48 year gentleman was admitted in our centre for chest wall swelling which has developed spontaneously 1 year back, painless, with cough impulse, further investigations like chest x-ray revealed nothing , subsequently CT thorax showed intercostal pleural hernia. He underwent surgery which diagnosed it as a case of intercostal pleural hernia having defect between 8th and 9th rib. Subsequently primary repair of defect was done with placement of monofilament mesh over it and then approximation of intercostal space was done with monofilament suture placed over 8th and 9th ribs. Post operatively patient had no complications and no recurrence of hernia. Spontaneous pleural herniation is a usually caused by coughing, heavy weight lifting, weakness of thoracic muscles by smoking, obesity etc. Ideal management is to treat the aetiology along with repair of the defect to prevent recurrence. In the present case the hernia developed after a bout of cough due to increased intercostal space between 8th and 9th ribs and also due to obesity leading to weak musculature. Intercostal pleural hernia repair can be achieved by primary repair of defect but it is advisable to use synthetic materials such as knitted monofilament polypropylene (Marlex) mesh to provide addition support to prevent recurrence.

Morphological indicators of subcutaneous implantation of monofilament mesh

Hernias are a significant, non-infectious animal condition. In productive animals, failure to provide surgical treatment leads to premature rejection and potential loss of their productive longevity. In small pets, this becomes a social problem for pet owners related to the keeping and death of affected animals. The aim of this study was to study the histological parameters of tissues during implantation of monofilament mesh in cattle for periods up to four months. The study was conducted on eight bulls of the Black Motley breed, divided into two groups of four animals. In the first group, four bulls received a subcutaneous implant of hernioplasty mesh made of polypropylene monofilament (Herniamesh S.R.I. Via CiRie 22 / A, San Maruro Torinese, Torino, Italy) in the area of the lateral soft abdominal wall on the right and left sides. In the second group, four bulls received implants in the middle third of the neck to the right and left sides. Thus, the subject of research was 16 wounds with implanted mesh. A sterile piece monofilament mesh, 1x2 cm in size and folded in half along the longitudinal side, was inserted vertically into the formed hypodermic pocket on the right side of the wound, in which it was possible to freely place the specified mesh. During the course of the study, Polycon No. 4 thread with intermittent knotted seams was used, and three sutures were applied. To ensure fixation of the mesh, it was stitched centrally. The material for histological studies was taken by biopsy at one, two, three and four months after implantation. Tissue was embedded in paraffin blocks, and sections were stained with haematoxylin-eosin and picrofuchsin according to Van Gieson. The results indicated that after subcutaneous implantation of monofilament mesh in the neck and abdominal wall in cattle, wound healing occurs by primary intention. It was revealed that from the beginning of the histological study to one month, the monofilament mesh is first overgrown with loose connective tissue. By the end of the study, after four months, this is sequentially differentiated into dense connective tissue. No significant differences were observed between the abdominal wall and neck area as sites of implantation, and morphological processes in both sites proceeded in the same way. Thus, the conducted studies allow us to conclude that monofilament mesh is a suitable material for closing the hernial ring in cattle, where it is not possible to use their own tissues for these purposes.

The mechanism of adhesion and graft polymerization of a PNIPAAm thermoresponsive hydrogel to polypropylene meshes

In this study, a commercial and fully flexible monofilament mesh has been used for the deposition of a thermosensitive hydrogel, generated by graft copolymerization of N-isopropylacrylamide (NIPAAm) and N,N′-methylene bis(acrylamide) (MBA) monomers.

Driftnets Catch Leatherback Turtles

In 1979 Japanese fishing vessels began using monofilament mesh driftnets to catch squid in international waters north-west of the Hawaiian Islands, between 35° and 45° N. This new fishery threatens the survival of leatherback turtles Dermochelys coriacea in their North Pacific feeding grounds and migration routes. It is only recently that the existence of leatherbacks in this remote oceanic area has been discovered and made known.