Effects of fibrin glue and growth factors released from platelets on abdominal hernia repair with a resorbable PGA mesh: experimental study

INTRODUCTION

The purpose of this study was to investigate if the strength and quality of an abdominal wall repair with a resorbable PGA (polyglycolic acid) mesh can be improved by fibrin glue or releasates from platelets.

MATERIALS AND METHODS

An abdominal wall defect in the rat was repaired using a PGA mesh in a sublay technique (CG) alone and either with additional fibrin glue (FG) or with platelet releasates (REL). Endpoints were clinical herniation pressure and hydroxyproline concentration (HP) as well as number of fibroblasts and collagen fibers at 7, 14, and 90 days after implantation.

RESULTS

In both experimental groups (REL and FG) higher herniation pressures, hydroxyproline contents, and number of fibroblasts/collagen fibers were found at all times of measurement compared to the CG. The PGA mesh alone showed a significant lack of stability after 14 days which can be compensated for by the investigated components. Significant differences (P < 0.05) were observed regarding the herniation pressure (REL vs CG at 7 and 14 days; FG vs CG at 14 days) and the number of collagen fibers (REL vs CG at 14 days).

CONCLUSIONS

These results suggest that the quality of a PGA mesh repair can be improved by application of fibrin glue or platelet releasates in the described experimental setting.

Is mesh fixation necessary in abdominal hernia repair? Results of an experimental study in the rat

BACKGROUND

Abdominal hernia repair with implantation of synthetic meshes using the sublay technique has resulted in low recurrence rates and high patient satisfaction.

AIM

The purpose of this experimental animal study was to investigate whether mesh fixation is necessary in abdominal hernia repair using a polypropylene mesh in the sublay technique.

METHODS

Forty-five rats were divided into three groups after creating an abdominal wall defect (CG control group, no mesh implantation; NoFixG mesh implantation without fixation group; SG mesh with suture fixation group) with 15 animals in each group. End-points were clinical herniation pressure, hydroxyproline (HP) concentration, mesh shape and number of fibroblasts/collagen fibres of the anchor zone 7, 14 and 90 days after implantation.

RESULTS

Herniation pressure, HP content and number of fibroblasts were similar between NoFixG and SG, although significantly higher in these groups than in the CG (P<0.05). Both mesh groups had significantly higher counts of fibroblasts and collagen fibres than the CG. Mesh shrinking occurred in both groups but was less in the SG.

CONCLUSION

Mesh fixation was not mandatory in abdominal hernia repair using this animal model.

[Rupture of the distal biceps tendon. Case report--modified after-care]

The surgical therapy of the rupture of a distal biceps tendon and a modified postoperative treatment is described. Mainpoint is the early treatment in anaclisis of Kleinert as it is standardized in the treatment of ruptures of the flexor tendons of the hand. A forearm orthesis with a simply ROM-joint without reboundmechanism was used. Possible benefits are shown and further industrial evolution seems to be indicated.

[Morphometry and histology of the eye of Callimico goeldii (Thomas 1904, callimiconidae primates) (author's transl)]

The histologic anatomy of the eye of Callimico goeldii is described and histometric data are communicated. The retina is treated with special attention. The eye of Callimico features all characteristics of a visual organ adapted to diurnal activity as is known from many higher primates and man. The well-differentiated Fovea centralis and the numerical relations of the three retinal neurons, which are clearly reduced from the periphery towards the center of the retina, indicate a particularly high degree of centralization ("Zentralisationsstufe" sensu Rohen). Similar numerical relations are found in the taxonomically related families Cebidae and Callithrichidae. A high degree of centralization is understood to facilitate a good visual resolution. The eyelid apparatus is differentiated like in other higher primates. The eye muscles contain extraordinarily many nervous-muscular entities that are interpreted to serve as nervous regulatory functions. The histologic results relate well with certain behavioral phenomena of this species.