New polymer for intra-abdominal meshes--PVDF copolymer.

Purpose: Full tissue integration without adhesion formation is still a challenge for intra-abdominal mesh materials. Purpose of this study was to investigate the adhesive potential and fibrocollagenous ingrowth of a polymer blend of polyvinylidene fluoride and hexafluorpropylene (co-PVDF), an established suture material in vascular surgery, when placed as a mesh in the intra-abdominal position. The results were compared with a matching polypropylene (PP) mesh.

A prospective observational cohort safety study of 5106 platelet transfusions with components prepared with photochemical pathogen inactivation treatment.

Background: Inactivation of pathogens and white blood cells in platelet (PLT) components with amotosalen and UVA light (INTERCEPT, Cerus Europe BV) has entered clinical practice in European blood centers. A prospective cohort study was implemented to characterize the safety profile of this new PLT component in a broad patient population.

Study Design And Methods: Apheresis or buffy-coat PLT components were leukoreduced, suspended in approximately 35 percent plasma and 65 percent PLT additive solution, and treated with the INTERCEPT process.

Macrophage and T-lymphocyte infiltrates in human peritoneal adhesions indicate a chronic inflammatory disease.

Background: Peritoneal adhesions are common and lead to significant clinical morbidity and mortality. Besides various individual factors, notably the inflammatory response to peritoneal defects affects adhesion formation. The aim of this study was to investigate whether there is inflammatory activity even in persistent adhesions.

Analysis of c-myc, PAI-1 and uPAR in patients with incisional hernias.

Background: Disturbed wound healing leading to alterations in collagen composition has been thought to play a key role in the pathogenesis of incisional hernia formation. The aim of the present study was to further characterise the scarring process in such patients.

Methods: Mature skin scars from patients with either primary or recurrent incisional hernias were compared to mature abdominal skin scars from patients without hernias.

A convenient and general iron-catalyzed hydrosilylation of aldehydes.

A general and highly chemoselective hydrosilylation of aldehydes using iron catalysts is reported. Fe(OAc)2 in the presence of tricyclohexylphosphine as ligand and polymethylhydrosiloxane (PMHS) as an economical hydride source forms an efficient catalyst system for the hydrosilylation of a variety of aldehydes. Aryl, heteroaryl, alkyl and alpha,beta-unsaturated aldehydes are successfully reduced to the corresponding primary alcohols.

Biomechanical analyses of overlap and mesh dislocation in an incisional hernia model in vitro.

Background: Incisional hernia repair is one of the most common surgical complications. Despite the introduction of mesh techniques of repair, recurrences are still prevalent. The aim of the current study was to evaluate the dependence of mesh dislocation on defect size, facial overlap, mesh-position, and orientation of the mesh in cases of anisotropic stretchability.

Biomechanical analyses of mesh fixation in TAPP and TEP hernia repair.

Background: Reliable laparoscopic fixation of meshes prior to their fibrous incorporation is intended to minimize recurrences following transabdominal preperitoneal hernia repair (TAPP) and totally extraperitoneal repair (TEP) repair of inguinal hernias. However, suture-, tack- and staple-based fixation systems are associated with postoperative chronic inguinal pain. Initial fixation with fibrin sealant offers an atraumatic alternative, but there is little data demonstrating directly whether fibrin-based mesh adhesion provides adequate biomechanical stability for repair of inguinal hernia by TAPP and TEP.

Morphology, quality, and composition in mature human peritoneal adhesions.

Background And Aim: Peritoneal adhesions are caused by intra-abdominal surgery and can lead to relevant complications. Adhesions are supposed to consist of avascular scar tissue. The aim of the present study was to analyze whether mature postsurgical adhesions even after years still reveal a dynamic remodeling process.

An environmentally benign process for the hydrogenation of ketones with homogeneous iron catalysts.

Iron complexes generated in situ catalyze homogeneously the transfer hydrogenation of aliphatic and aromatic ketones by utilizing 2-propanol as a hydrogen donor in the presence of base. The influence of different reaction parameters on the catalytic activity is investigated in detail by applying a three-component catalyst system composed of an iron salt, 2,2':6',2''-terpyridine, and PPh3. The scope and limitations of the described catalyst is shown in the reduction of 11 different ketones.

Regulation of MMP-2 gene transcription in dermal wounds.

Matrix metalloproteinase-2 (MMP-2, gelatinase A) plays an essential role in angiogenesis, inflammation, and fibrosis. These processes are critical for wound healing and accordingly elevated levels of MMP-2 expression have been detected after skin injury. Our goal was to investigate the transcriptional activation of the MMP-2 gene in a model of skin injury by using two different MMP-2/LacZ-reporter mice.

Fibrin sealant for mesh fixation in Lichtenstein repair: biomechanical analysis of different techniques.

Background: Mesh fixation using sealants is becoming increasingly popular in hernia surgery. Fibrin sealant is an atraumatic alternative to suture or stapler fixation and is currently the most frequently used sealant. There are currently no biomechanical data available for evaluation of the quality of adhesion achieved with fibrin sealant during Lichtenstein hernia repair.

Improved collagen type I/III ratio at the interface of gentamicin-supplemented polyvinylidenfluoride mesh materials.

Background: Formation of recurrent inguinal and incisional hernia shows an underlying defect in the wound-healing process with an insufficient quality of scar formation. Even after mesh repair an altered collagen formation and insufficient mesh integration has been found as main reason for recurrences. Therefore, the development of bioactive mesh materials to achieve a local modification of the scar formation to improve patients outcome is advisable.

Gas-related impact of pneumoperitoneum on systemic wound healing.

Introduction: The aim of the present study was to investigate the gas-dependent effects of pneumoperitoneum on wound healing distant from the abdomen.

Materials And Methods: Dorsal skin incisions were performed in 54 male Sprague-Dawley rats. A CO(2) or a helium pneumoperitoneum of 3 mmHg was maintained before, with an overall duration of 30 min (each n = 18).

Collagen in colon disease.

The pathophysiology of wound healing in the bowel wall suggests that collagen and matrix metalloproteinases (MMPs) have an important role in the changes of the bowel wall seen in several colonic diseases. Several recent studies suggest that disturbances of the collagen texture and the extracellular matrix (ECM) metabolism are major factors leading to the onset of diverticular disease. Changes of the ECM also play a role in the development of inflammatory bowel diseases.

Modification of collagen formation using supplemented mesh materials.

Background: Formation of recurrent inguinal and incisional hernia shows an underlying defect in the wound healing process. Even following mesh repair an altered collagen formation and insufficient mesh integration has been found as main reason for recurrences. Therefore the development of bioactive mesh materials to achieve a local modification of the scar formation to improve patients outcome is advisable.

Improved abdominal wall wound healing by helium pneumoperitoneum.

Background: Despite widespread use of the endoscopic technique in the treatment of inguinal and incisional hernias, knowledge about its impact on abdominal wall wound healing is rare. Questions remain regarding the risk of port-site hernias and hernia recurrence. The current study investigated the gas-dependent effects of pneumoperitoneum on laparotomy wound healing.

Laparoscopy and collagen metabolism.

The collagens represent a vital component within the wound healing process and physiological scar formation. Therefore, analysing the influence of new operative procedures on collagen metabolism is of great surgical interest. As the endoscopic technique has, nowadays, become routinely applied for diverse abdominal diseases worldwide, we present a review of literature facing its impact on collagen biology.

Different matrix micro-environments in colon cancer and diverticular disease.

Background And Aims: The extracellular matrix and the interactive signalling between its components are thought to play a pivotal role for tumour development and metastasis formation. An altered matrix composition as potential underlying pathology for the development of colorectal cancer was hypothesized.

Methods: In a retrospective study of patients with colon cancer, the extracellular matrix in tumour-free bowel specimen was investigated in comparison with non-infected bowel specimen from patients operated on for colonic diverticulosis.

Hernia fibroblasts lack beta-estradiol-induced alterations of collagen gene expression.

Background: Estrogens are reported to increase type I and type III collagen deposition and to regulate Metalloproteinase 2 (MMP-2) expression. These proteins are reported to be dysregulated in incisional hernia formation resulting in a significantly decreased type I to III ratio. We aimed to evaluate the beta-estradiol mediated regulation of type I and type III collagen genes as well as MMP-2 gene expression in fibroblasts derived from patients with or without history of recurrent incisional hernia disease.

Light weight meshes in incisional hernia repair.

Incisional hernias remain one of the most common surgical complications with a long-term incidence of 10-20%. Increasing evidence of impaired wound healing in these patients supports routine use of an open prefascial, retromuscular mesh repair. Basic pathophysiologic principles dictate that for a successful long-term outcome and prevention of recurrence, a wide overlap underneath healthy tissue is required.

Risk factors related to recurrence in inguinal hernia repair: a retrospective analysis.

The aim of this study was to analyze and evaluate the long-term recurrence rate and risk factors for inguinal hernia recurrence in patients treated by the Shouldice suture repair. A total of 293 hernias treated by Shouldice suture technique in 1992 were studied retrospectively. After a 10-year follow-up, 15 potential risk factors for recurrence were assessed in 142 patients undergoing 171 Shouldice repairs.

Bacterial incorporation of leucine into protein down to -20 degrees C with evidence for potential activity in sub-eutectic saline ice formations.

Direct evidence for metabolism in a variety of frozen environments has pushed temperature limits for bacterial activity to increasingly lower temperatures, so far to -20 degrees C. To date, the metabolic activities of marine psychrophilic bacteria, important components of sea-ice communities, have not been studied in laboratory culture, not in ice and not below -12 degrees C. We measured [3H]-leucine incorporation into macromolecules (further fractionated biochemically) by the marine psychrophilic bacterium Colwellia psychrerythraea strain 34H over a range of anticipated activity-permissive temperatures, from +13 to -20 degrees C, including expected negative controls at -80 and -196 degrees C.

Transfusion of 7-day-old amotosalen photochemically treated buffy-coat platelets to patients with thrombocytopenia: a pilot study.

Background: Photochemical treatment (PCT) of platelets (PLTs) with amotosalen and ultraviolet A light to inactivate bacteria may facilitate extension of storage from 5 to 7 days.

Study Design And Methods: A randomized, double-blinded, crossover, noninferiority, single-site pilot study utilizing pooled buffy-coat PLTs was conducted. The primary endpoint was the 1-hour corrected count increment (CCI) after one transfusion each of 7-day-old PCT and reference (R) PLT components.