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Adhesion Formation (adhesion + formation)
Kinds of Adhesion Formation Selected AbstractsAddition of nimesulide to small intestinal submucosa biomaterial inhibits postsurgical adhesiogenesis in ratsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2010Mark A. Suckow Abstract Adhesion formation is a common complication in abdominal surgery with incidence as high as 93% and small bowel obstruction a common complication. Because the extracellular matrix material, small intestinal submucosa (SIS), is commonly used in various surgical procedures, methods to inhibit adhesiogenesis are of great interest. This study was undertaken to determine if incorporation of nimesulide (NM), a selective cyclooxygenase (COX)-2 inhibitor, could reduce the extent and tenacity of intraabdominal adhesion formation associated with SIS implantation. Female Sprague,Dawley rats underwent a cecal abrasion surgical procedure to induce adhesiogenesis. Rats were either left untreated or treated by direct application over the injured cecum with polypropylene mesh (PPM); SIS; SIS containing a low dose of NM; or SIS containing a high dose of NM. Rats were euthanized 21 days later, and adhesion extent and tenacity were evaluated using standard scales (0 = minimal adhesiogenesis; 4 = severe adhesiogenesis). Addition of NM to SIS resulted in a significant (p < 0.05) reduction in adhesion extent and in a similar reduction in adhesion tenacity for SIS containing a low dose of NM. Adhesions typically extended from the abraded cecal surface to the body wall and were characterized histologically by fibrous tissue adherent to the cecal wall. In conclusion, addition of the nonsteroidal anti-inflammatory, COX-2 selective drug, NM, to SIS attenuates adhesion extent and tenacity when compared with surgical placement of SIS or PPM alone. © 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2010 [source] The new adhesion prophylaxis membrane A-part®,From in vitro testing to first in vivo resultsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2009Bernd Martin Jaenigen Abstract Introduction: Formation of postoperative intra-abdominal adhesions is a severe problem in surgery. Apart from standard surgical procedures, a variety of different substances is available to prevent adhesions, but no universal method has been developed so far. A membrane consisting of polyvinyl alcohol (PVA) and carboxymethylcellulose (CMC) has been demonstrated to be antiadhesive. Here, the in vitro testing and first in vivo results in a rabbit sidewall model are reported. Materials and Methods: A-part® membrane contains a PVA/CMC mixture in a thickness of 40 ,m. The composition, dissolution, tensile strength, and elasticity were examined to characterize the membrane in vitro. Experiments in vivo were carried out using a ,rabbit sidewall model' in which a standardized peritoneal trauma was covered with a 5 × 6 cm A-part® membrane. Adhesion formation in A-part®-treated animals was compared with that in Adept® (15 mL/kg body weight) and untreated controls. Results: An 80/20 PVA/CMC mixture forms a stable, elastic, transparent membrane, which can easily be placed intraoperatively. The dissolution shows a half-life of about 2 weeks [day 15: (45.1 ± 4.9)% SD], which affords good adhesion protection during the initial critical phase of adhesion formation. In wet conditions, the membrane follows abdominal movements without tearing (tensile strength 5.0 ± 4.2 N/cm SD; elasticity 29.5%). In a rabbit sidewall model, A-part® membrane significantly reduced adhesion development by (83.1 ± 31.5)% SD compared with the control and the Adept group (p < 0.001). Conclusion: The properties of the A-part® membrane suggest that it may be useful as an antiadhesive in surgery. A-part® is effective in invivo testing as determined in a rabbit sidewall model. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2009 [source] Standing laparoscopic herniorrhaphy in stallions using cylindrical polypropylene mesh prosthesisEQUINE VETERINARY JOURNAL, Issue 1 2001T. MARIËN Summary Standing laparoscopic herniorrhaphy was performed in 9 stallions. Appropriate analgesia was achieved by sedation with detomidine and local flank infiltration with mepivacaine. Three portal sites at the paralumbar fossa were used to perform the herniorrhaphy by means of triangulation. A cylindrical polypropylene mesh was inserted and fixated in the inguinal canal. Subsequent adhesion formation resulted in an obliterated inguinal canal within 2 weeks. This minimal invasive technique allowed us to perform a testis sparing herniorrhaphy in the standing horse. [source] Addition of nimesulide to small intestinal submucosa biomaterial inhibits postsurgical adhesiogenesis in ratsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2010Mark A. Suckow Abstract Adhesion formation is a common complication in abdominal surgery with incidence as high as 93% and small bowel obstruction a common complication. Because the extracellular matrix material, small intestinal submucosa (SIS), is commonly used in various surgical procedures, methods to inhibit adhesiogenesis are of great interest. This study was undertaken to determine if incorporation of nimesulide (NM), a selective cyclooxygenase (COX)-2 inhibitor, could reduce the extent and tenacity of intraabdominal adhesion formation associated with SIS implantation. Female Sprague,Dawley rats underwent a cecal abrasion surgical procedure to induce adhesiogenesis. Rats were either left untreated or treated by direct application over the injured cecum with polypropylene mesh (PPM); SIS; SIS containing a low dose of NM; or SIS containing a high dose of NM. Rats were euthanized 21 days later, and adhesion extent and tenacity were evaluated using standard scales (0 = minimal adhesiogenesis; 4 = severe adhesiogenesis). Addition of NM to SIS resulted in a significant (p < 0.05) reduction in adhesion extent and in a similar reduction in adhesion tenacity for SIS containing a low dose of NM. Adhesions typically extended from the abraded cecal surface to the body wall and were characterized histologically by fibrous tissue adherent to the cecal wall. In conclusion, addition of the nonsteroidal anti-inflammatory, COX-2 selective drug, NM, to SIS attenuates adhesion extent and tenacity when compared with surgical placement of SIS or PPM alone. © 2010 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2010 [source] The new adhesion prophylaxis membrane A-part®,From in vitro testing to first in vivo resultsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2009Bernd Martin Jaenigen Abstract Introduction: Formation of postoperative intra-abdominal adhesions is a severe problem in surgery. Apart from standard surgical procedures, a variety of different substances is available to prevent adhesions, but no universal method has been developed so far. A membrane consisting of polyvinyl alcohol (PVA) and carboxymethylcellulose (CMC) has been demonstrated to be antiadhesive. Here, the in vitro testing and first in vivo results in a rabbit sidewall model are reported. Materials and Methods: A-part® membrane contains a PVA/CMC mixture in a thickness of 40 ,m. The composition, dissolution, tensile strength, and elasticity were examined to characterize the membrane in vitro. Experiments in vivo were carried out using a ,rabbit sidewall model' in which a standardized peritoneal trauma was covered with a 5 × 6 cm A-part® membrane. Adhesion formation in A-part®-treated animals was compared with that in Adept® (15 mL/kg body weight) and untreated controls. Results: An 80/20 PVA/CMC mixture forms a stable, elastic, transparent membrane, which can easily be placed intraoperatively. The dissolution shows a half-life of about 2 weeks [day 15: (45.1 ± 4.9)% SD], which affords good adhesion protection during the initial critical phase of adhesion formation. In wet conditions, the membrane follows abdominal movements without tearing (tensile strength 5.0 ± 4.2 N/cm SD; elasticity 29.5%). In a rabbit sidewall model, A-part® membrane significantly reduced adhesion development by (83.1 ± 31.5)% SD compared with the control and the Adept group (p < 0.001). Conclusion: The properties of the A-part® membrane suggest that it may be useful as an antiadhesive in surgery. A-part® is effective in invivo testing as determined in a rabbit sidewall model. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2009 [source] Modulation of peritendinous adhesion formation by alginate solution in a rabbit flexor tendon modelJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2007Jiro Namba Abstract To examine the antiadhesive effect of an alginate solution following tendon surgery, unilateral subtotal laceration of the flexor digitorum communis tendon was created in one hind limb while the other side was left intact in 32 Japanese white rabbits. The lesion was coated with alginate solution in 16 animals and not coated in the other 16. Degree of adhesion formation was assessed histologically and biomechanically by measuring the flexion angle of the first toe when the flexor digitorum tendon was pulled with a specified force at 4 weeks postoperatively. When compared with the control group, the alginate-treated group demonstrated significantly greater toe flexion, with less scar tissue formation at the repair site. Histologically, complete tendon healing with longitudinal remodeling of collagen fibers was observed in the alginate-treated group, while a random pattern of fibers was observed in the control group. Reduction in adhesion formation using alginate solution represents a novel strategy for the management of tendon injury and repair in the clinical setting. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2007 [source] The effect of tranexamic acid in fibrin sealant on adhesion formation in the rat,JOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2004David Wiseman Abstract The objective of the research was to determine the effect of the type, dose, and volume of anti-fibrinolytic agents (tranexamic acid, aprotinin) added to fibrin formulations, on adhesion development. Adhesions were induced in 228 male rats by creating apposing parietal and visceral peritoneal defects. Animals were randomized to receive no treatment or a fibrin formulation containing aprotinin or tranexamic acid. Seven days later the incidence of adhesions, and the force and energy required to detach them, were determined. Adhesions developed in 13/13 rats in the control and aprotinin groups. Treatment with fibrin (100 mg/ml tranexamic acid) resulted in adhesions in 4/14 rats (as strips, p , 0.0005), 4/10 rats (as spray, p , 0.0036), and 12/15 rats (by drip). The reduction of adhesions was dependent on the concentration of tranexamic acid with strip and spray application. Using commercial formulations, tranexamic-acid,containing fibrin (10/15, p = 0.042), but not aprotinin-containing fibrin (13/15), reduced the incidence of side-wall adhesions from 15/15 in controls. Fibrin containing either tranexamic or aprotinin reduced the incidence and severity of adhesions. This effect was greater when tranexamic acid was used and was dependent on the mode of administration, the volume, and to a degree, the concentration of tranexamic acid. © 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 68B: 222,230, 2004 [source] Healing process induced by three composite prostheses in the repair of abdominal wall defectsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2002Juan M. Bellón Abstract The present study compared the performance of three composite prostheses used to repair abdominal wall defects in rabbits. Two of them [Parietex Composite® (PC) and Composix® (CS)] are commonly used in clinical practice and one was designed by the present team (PL-PU99). At 14 and 90 days postimplant, specimens were obtained for morphological, macrophage response (RAM-11) and morphometric and biomechanical analysis. The prosthetic area covered by adhesions was significantly greater (p < 0.05) in the CS group (6.83 ± 2.31 cm2) than in PC (0.11 ± 0.02 cm2) or PL-PU99 (0.10 ± 0.07 cm2). At 14 days, it was observed a homogeneous, organized, well-vascularized neoperitoneum that was significantly thicker (p < 0.05) in PL-PU99. Except in the CS implants, this layer was covered by a continuous mesothelium. All three composites achieved good recipient tissue integration. Highest macrophage levels were recorded at 14 days with significantly higher values in the PL-PU99 prosthesis. Biomechanical strength was significantly greater (p < 0.05) in CS at two weeks postimplant, but it was similar at 90 days. These findings suggest that the three composites show ideal integration with host tissue, along with similar biomechanical strength at 90 days, and significantly higher adhesion formation is induced by the CS prosthesis, possibly due to incomplete mesothelialization of the lower prosthetic surface. © 2002 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Biomater) 63: 182,190, 2002; DOI 10.002/jbm.10123 [source] Experimental Efficacy of Pericardial Instillation of Anti-inflammatory Agents during Percutaneous Epicardial Catheter Ablation to Prevent Postprocedure PericarditisJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 11 2007ANDRE D'AVILA M.D. Introduction: Pericarditis is a potential complication of catheter-based percutaneous epicardial mapping and ablation. This study evaluates the efficacy and safety of intrapericardial instillation of anti-inflammatory agents after pericardial mapping and ablation in a porcine model of postprocedural pericarditis. Methods and Results: Twenty-five healthy swine underwent epicardial mapping and ablation after transthoracic subxyphoid puncture. After 60 minutes of continuous catheter manipulation in the pericardial space, radiofrequency energy was delivered in a linear fashion to the epicardial surfaces of both atria. The animals were randomly divided to receive the anti-inflammatory agents, Hyaluronic Acid and Triamcinolone, or control. Fourteen days after ablation, the hearts were excised and the degree of pericardial reaction/adhesions scored. The severity was uniformly graded 4 (intense) in all control animals and was characterized by intense adhesion between the parietal and the visceral pericardium obscuring tissue planes and epicardial anatomy. Hyaluronic Acid provided a mild benefit (score 3.0 ± 0.9), but 2 mg/kg of Triamcinolone significantly attenuated the inflammatory effect (all animals uniformly scored 1.0). Conclusion: In a porcine model of ablation-related pericarditis, intrapericardial instillation of 2 mg/kg of intermediate-acting corticosteroids effectively prevents post-procedure inflammatory adhesion formation. [source] Disruption of FRNK expression by gene targeting of the intronic promoter within the focal adhesion kinase geneJOURNAL OF CELLULAR BIOCHEMISTRY, Issue 4 2007Haruko Hayasaka Abstract FRNK, a non-catalytic variant of focal adhesion kinase (FAK), is expressed in major blood vessels throughout mouse development and is postulated to play a role in regulating cell adhesion and signaling in vascular smooth muscle cells (VSMCs). The FRNK transcriptional start site lies within an intron of the FAK gene, suggesting that the FRNK gene is a "gene within a gene". Here, we identified a 1 kb intronic sequence of the FAK gene that is necessary for endogenous FRNK expression. Deletion of this sequence in gene-targeted mice abolished FRNK expression, showing the direct involvement of the FAK intron in the regulation of FRNK expression. The level of FAK expression was normal in the FRNK-deficient mice, indicating that FAK and FRNK are transcriptionally regulated by distinct promoters. The FRNK-deficient mice were viable, fertile, and displayed no obvious histological abnormalities in any of the major blood vessels. Western blot analysis showed that FRNK,deficient and wild-type (WT) cells had comparable levels of steady-state and adhesion-dependent FAK autophosphorylation. Despite the fact that ectopic expression of FRNK suppresses focal adhesion formation in cultured cells, these results suggest that endogenous FRNK is not essential for development or the formation of the mouse vasculature. J. Cell. Biochem. 102: 947,954, 2007. © 2007 Wiley-Liss, Inc. [source] PR-39 coordinates changes in vascular smooth muscle cell adhesive strength and locomotion by modulating cell surface heparan sulfate,matrix interactionsJOURNAL OF CELLULAR PHYSIOLOGY, Issue 2 2001John H. Chon PR-39 is proline-rich peptide produced at sites of tissue injury. While the functional properties of this peptide have not been fully defined, PR-39 may be an important regulator of processes related to cell-matrix adhesion since it reportedly upregulates syndecan-4, which is a critical determinant of focal adhesion formation. The ability of PR-39 to modulate the adhesion and chemokinetic migration behavior of arterial smooth muscle cells (SMCs) in a fashion coordinated with syndecan-4 expression was investigated. Treatment of SMCs with PR-39 did not alter syndecan-1 mRNA, but did induce a two-fold increase in syndecan-4 mRNA (P,<,0.0001) and significantly enhanced cell surface expression of both syndecan-4 (P,<,0.01) and heparan sulfate (HS) (P,<,0.05). These observations were consistent with an observed increase in cell-matrix adhesive strength (P,<,0.05) and a reduction in cell speed (P,<,0.01) on fibronectin-coated substrates. Incubation of PR-39 treated cells with a soluble fibronectin derived heparin-binding peptide, as a competitive inhibitor of heparan sulfate/matrix interactions, abolished these effects. These data suggest that PR-39 mediated alterations of cell adhesion and motility may be related, in part, to the increased expression of heparan sulfate glycosaminoglycans (GAGs) that accompany the upregulation of cell surface syndecan-4. Futhermore, this investigation supports the notion that factors which control syndecan-4 expression may play an important role in regulating adhesion related cell processes. © 2001 Wiley-Liss, Inc. [source] The cytoplasmic tail of the ,3 integrin subunit promotes neurite outgrowth in PC12 cellsJOURNAL OF NEUROSCIENCE RESEARCH, Issue 6 2005Nadja Mechai Abstract Binding of integrins to proteins of the extracellular matrix (ECM) provides structural and signaling information for biological processes such as cell proliferation, migration, neurite outgrowth, and differentiation. Integrins represent a family of heterodimeric transmembrane cell surface receptors. Besides connecting the ECM with the cytoskeleton, integrins also induce various signaling pathways in response to ligand binding. Integrin ligation leads to cytoplasmic protein,protein interactions requiring both integrin cytoplasmic tails. These sequences are initiation points for focal adhesion formation and subsequent signal transduction cascades. In this study, we addressed the question of whether the short cytoplasmic tail of the ,3 integrin subunit of ,3,1 integrin is required for ,3,1 integrin-dependent processes. For this purpose, cDNA representing the extracellular and transmembrane domain of the interleukin 2 receptor (IL2R) , subunit and the cytoplasmic sequence of the ,3 integrin subunit was transfected into PC12 cells. Autonomous expression of the cytoplasmic ,3 tail does not affect attachment but leads to inhibition of neuronal differentiation on laminin 5. This indicates that the cytoplasmic ,3 sequence is not required for cell attachment but is necessary for long-term adhesion and for the reorganization of the cytoskeleton that precedes neuronal differentiation. Inhibition of neurite outgrowth by chimeric IL2R-,3 can be rescued by treatment of transfected cells with the pharmacological inhibitor Y27632, which inhibits the RhoA downstream effector Rho kinase ,. © 2005 Wiley-Liss, Inc. [source] Use of a bioscaffold to improve healing of a patellar tendon defect after graft harvest for ACL reconstruction: A study in rabbitsJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2008Sinan Karaoglu Abstract Following harvest of a bone-patellar tendon-bone (BPTB) autograft, the central third of the patellar tendon (PT) does not heal well. The healing tissues also form adhesions to the fat pad and can cause abnormal patellofemoral joint motion. The hypotheses were that a bioscaffold could enhance patellar tendon healing through contact guidance and chemotaxis, and the scaffold could serve as a barrier to decrease adhesion formation between the neo-PT and infrapatellar fat pad. In 20 New Zealand White rabbits, a central-third PT defect was created. One strip of porcine small intestinal submucosa (SIS) was attached to both the anterior and posterior sides of the PT defect of the SIS-treated group (n,=,10). For comparison, a central defect was left nontreated (n,=,10). At 12 weeks, histomorphology was examined using Masson's trichrome staining. The cross-sectional area (CSA) was determined with a laser micrometer, and the central BPTB complexes were tested in uniaxial tension. SIS-treated samples showed a greater amount of healing tissue with denser and well-oriented collagen fibers and more spindle-shaped cells. There was no noticeable adhesion formation in the SIS-treated group. For the nontreated group, there were significantly more and diffuse adhesive formations. The SIS-treated group also had a 68% increase in neo-PT CSA, 98% higher stiffness, and 113% higher ultimate load than that in the nontreated group. SIS treatment increased the quantity of healing tissue, improved the histological appearance and biomechanical properties of the neo-PT, and prevented adhesion formation between the PT and fat pad. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:255,263, 2008 [source] Regulation of implant surface cell adhesion: characterization and quantification of S-phase primary osteoblast adhesions on biomimetic nanoscale substratesJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2007Manus J.P. Biggs Abstract Integration of an orthopedic prosthesis for bone repair must be associated with osseointegration and implant fixation, an ideal that can be approached via topographical modification of the implant/bone interface. It is thought that osteoblasts use cellular extensions to gather spatial information of the topographical surroundings prior to adhesion formation and cellular flattening. Focal adhesions (FAs) are dynamic structures associated with the actin cytoskeleton that form adhesion plaques of clustered integrin receptors that function in coupling the cell cytoskeleton to the extracellular matrix (ECM). FAs contain structural and signalling molecules crucial to cell adhesion and survival. To investigate the effects of ordered nanotopographies on osteoblast adhesion formation, primary human osteoblasts (HOBs) were cultured on experimental substrates possessing a defined array of nanoscale pits. Nickel shims of controlled nanopit dimension and configuration were fabricated by electron beam lithography and transferred to polycarbonate (PC) discs via injection molding. Nanopits measuring 120 nm diameter and 100 nm in depth with 300 nm center,center spacing were fabricated in three unique geometric conformations: square, hexagonal, and near-square (300 nm spaced pits in square pattern, but with ±50 nm disorder). Immunofluorescent labeling of vinculin allowed HOB adhesion complexes to be visualized and quantified by image software. Perhipheral adhesions as well as those within the perinuclear region were observed, and adhesion length and number were seen to vary on nanopit substrates relative to smooth PC. S-phase cells on experimental substrates were identified with bromodeoxyuridine (BrdU) immunofluorescent detection, allowing adhesion quantification to be conducted on a uniform flattened population of cells within the S-phase of the cell cycle. Findings of this study demonstrate the disruptive effects of ordered nanopits on adhesion formation and the role the conformation of nanofeatures plays in modulating these effects. Highly ordered arrays of nanopits resulted in decreased adhesion formation and a reduction in adhesion length, while introducing a degree of controlled disorder present in near-square arrays, was shown to increase focal adhesion formation and size. HOBs were also shown to be affected morphologicaly by the presence and conformation of nanopits. Ordered arrays affected cellular spreading, and induced an elongated cellular phenotype, indicative of increased motility, while near-square nanopit symmetries induced HOB spreading. It is postulated that nanopits affect osteoblast,substrate adhesion by directly or indirectly affecting adhesion complex formation, a phenomenon dependent on nanopit dimension and conformation. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:273,282, 2007 [source] Intraperitoneal Insemination in Mammals: A ReviewREPRODUCTION IN DOMESTIC ANIMALS, Issue 2 2002JL Yaniz Contents This review focuses on factors associated with the development of intraperitoneal insemination in mammals. Findings to date indicate that fertility improves as the sperm cell concentration rises, but that the optimal sperm number differs in each species. Sperm washing before intraperitoneal insemination favours fertility. Peritoneal fluid shows a variable effect on spermatozoa, depending on the hormonal status of the female. The optimal time for insemination appears to be just prior to ovulation. The technique may be performed either through the abdominal or the vaginal wall. Verification of sperm deposition in the proximity of the ovaries improves fertility rates. Although associated with some risk of infection and an immune reaction against spermatozoa, the intraperitoneal technique rarely gives rise to severe anaphylactic shock, peritonitis, adhesion formation and the production of anti-sperm antibodies and these complications may be prevented by adequate sperm pretreatment and antibiotic therapy. The success of intraperitoneal insemination in humans, with results comparable with those of intrauterine insemination in the treatment of infertility, suggest the potential use of this technique in domestic mammals, especially in those in which intrauterine insemination poses practical difficulties. Some of the methods applied in human intraperitoneal insemination, such as confirming the position of the needle in the peritoneal cavity, and sperm pre-treatments might also improve results in domestic species. Conversely, the use of the animal model should help to develop some aspects of this technique in humans. [source] TRAM flap delay: an extraperitoneal laparoscopic techniqueANZ JOURNAL OF SURGERY, Issue 10 2005Ardalan Ebrahimi Although the transverse rectus abdominis musculocutaneous (TRAM) flap is the gold standard in autogenous breast reconstruction, it is less reliable in patients at high risk of ischaemic compromise. A preliminary delay procedure involving ligation of the deep inferior epigastric vessels has been shown to augment flap vascularity and improve outcome in those high risk patients undergoing unipedicled TRAM flap reconstruction. Despite previous description of a transperitoneal laparoscopic technique, surgical delay generally continues to be performed as an open procedure. This may reflect apprehension over the transperitoneal approach with its attendant risk of injury to intra-abdominal organs and vessels as well as adhesion formation. In this paper we describe an extraperitoneal laparoscopic technique for TRAM flap delay. Access to the deep inferior epigastric vessels is obtained using an extraperitoneal approach similar to that used for total extraperitoneal laparoscopic inguinal hernia repair and the vessels are easily identified and ligated using a single working port. While further study is required to evaluate the safety and efficacy of this technique, we report this as an alternative to the known open procedure which may be particularly useful for bilateral TRAM flap delay with the potential for reduced operative time, postoperative pain and scarring by avoiding bilateral inguinal incisions. [source] Application of Polycaprolactone as an Anti-Adhesion Biomaterial FilmARTIFICIAL ORGANS, Issue 8 2010Hsien-Yi Lo Abstract Adhesions are unavoidable consequences of surgery and other trauma. How to prevent the adhesions remains a big issue in healthcare system. The objective of this study is to test the efficacy of polycaprolactone (PCL) films as physical barriers in reducing postoperative intra-abdominal adhesions in the rat cecum-abdominal wall model. PCL is quite cheap compared with the agents recently used in the market. The fabrication method is also very easy to perform. Scanning electron microscope (SEM) showed multiple pores over upper and bottom surfaces but too small to permit cells to migrate from one surface onto another surface. Those pores were proven to be not interconnected. The PCL film did not show any evidence of cytotoxic effects as it did not induce any significant increase in cytoplasmic lactate dehydrogenase release from the NIH3T3 cells that it came in contact with. In animal studies, the PCL films led to fewer adhesions than Seprafilm in rat adhesion model. PCL films were efficacious in reducing postoperative intra-abdominal adhesion formation in rat cecum-abdominal wall models. [source] Reduced adhesion formation following laparoscopic versus open colorectal surgery (Br J Surg 2008; 95: 909,914)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2008B. Ansari No abstract is available for this article. [source] Sphingosine kinase 1 gene transfer reduces postoperative peritoneal adhesion in an experimental modelBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2008Q. Guo Background: Recovery of the surgically damaged mesothelial cell layer is a major process in reducing postoperative peritoneal adhesions. Sphingosine kinase (SPK) 1 is a signalling molecule involved in the regulation of proliferation and migration of various cell types. This study determined the effect of SPK-1 gene transfer on the recovery of damaged mesothelial cells and on peritoneal adhesion formation after surgery. Methods: Rat mesothelial cells were isolated and characterized by their expression of cytokeratin and vimentin. Their migration was determined by scratch wound motility assay. Cellular SPK-1 activity was measured by [,- 32P]adenosine 5,-triphosphate incorporation. Wistar rats underwent laparotomy with subsequent caecum or uterine horn abrasion. Rats were randomized to either SPK-1 gene (Ad-SPK-1) transfer or control groups. The animals were killed 14 days after operation and peritoneal adhesions were graded. Results: Adenovirus-mediated SPK-1 gene transfer increased the cellular SPK-1 activity of mesothelial cells, leading to enhanced migration. Median adhesion scores were significantly lower in the Ad-SPK-1 group than in controls in both rat caecum (0·98 versus 2·60; P < 0·001) and rat uterine horn (0·28 versus 1·83; P < 0·001) models. Conclusion: Adenovirus-mediated SPK-1 gene transfer promotes recovery of the surgically damaged mesothelial cell layer and prevents postoperative peritoneal adhesion formation. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Glove powder promotes adhesion formation and facilitates tumour cell adhesion and growthBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2001M. P. van den Tol Background: The presence of foreign material in the abdominal cavity irritates the peritoneal surface, leading to an inflammatory response. This defensive mechanism can provoke adhesion formation. The same peritoneal defence cascade is thought to play a role in the process of intra-abdominal tumour recurrence. The aim of this study was to evaluate whether glove powder produced peritoneal adhesions in a rat adhesion model and whether it promoted intra-abdominal tumour recurrence in a rat tumour cell adhesion and growth model. Methods: A reproducible model that allowed semiquantitative scoring of adhesion formation or tumour load was used in three different groups of rats. One group was treated by intra-abdominal application of powder obtained from starch-powdered gloves, one by application of pure starch and in one group no powder was used. Results: Application of glove powder or pure starch on minimally and severely traumatized peritoneum gave rise to significantly greater adhesion formation and intra-abdominal tumour load than peritoneal trauma alone (both P < 0·001). Conclusion: Starch-induced peritoneal trauma leads not only to more adhesion formation but also to increased adhesion and growth of tumour cells. Since good powder-free alternatives are available there is no longer any justification for the use of powdered gloves during intra-abdominal surgery. © 2001 British Journal of Surgery Society Ltd [source] Neoadjuvant antiangiogenic therapy with tamoxifen does not impair gastrointestinal anastomotic repair in the ratCOLORECTAL DISEASE, Issue 4 2003D. A. McNamara Abstract Introduction Antiangiogenic therapy has the potential to moderate tumour and micrometastatic growth. Its use in the perioperative period is attractive but its potential to compromise wound and anastomotic healing is a cause for concern. Tamoxifen is antiangiogenic but also favourably modifies some aspects of wound healing. We hypothesised that tamoxifen would not adversely affect skin wound and gut anastomotic healing. Methods A previously established model of tamoxifen, administered orally at antiangiogenic doses (20 mg/ml arachais oil/day), was used. Animals received two days pretreatment prior to laparotomy and small bowel anastomosis. Treatment was continued until completion of the study. The principal outcome measures are survival, macroscopic wound and anastomotic healing, anastomotic bursting pressure and PVA sponge granuloma hydroxyproline (OHP) content. Results Tamoxifen treated animals had fewer complications of skin wound healing than controls (4.5%vs. 19.5%; ,2 4.65, 1 d.f., P < 0.05). There was no significant difference in adhesion formation or macroscopic complications of anastomotic healing. Anastomotic bursting pressure was greater in tamoxifen treated animals at postoperative day 3 (39 ± 4.4 vs. 22.5 ± 3.5 mmHg; P < 0.01) and equal to that of controls on postoperative day 5 (144.4 ± 9.4 vs. 127.3 ± 10.9 mmHg; P = ns). Tamoxifen treated animals weighed significantly less than placebo controls from postoperative day 3 with no difference in mortality between groups (,2 = 0.06, 1df, P = ns). PVA sponge granuloma OHP content on day 7 was higher in tamoxifen-treated animals (2.93 ± 0.4 vs. 1.4 ± 0.4 mg OHP/mg dry sponge weight; P = 0.03). Conclusion Antiangiogenic therapy with tamoxifen has no demonstrable adverse effects on wound or anastomotic repair and its perioperative use is compatible with successful early surgical outcomes. [source] Acetaldehyde plasma polymer-coated PET fibers for endothelial cell patterning: Chemical, topographical, and biological analysisJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2010Afra Hadjizadeh Abstract The objective of this study was to produce fibrous biomaterials with cell adhesive and cell repulsive capabilities for biomedical applications. To this aim, the surface of 100-,m diameter polyethylene terephthalate fibers were functionalized with acetaldehyde plasma polymer deposition followed by carboxymethyl dextran grafting onto the aldehyde-coated surfaces via a polyethyleneimine interlayer. The performance of the surface modification steps were confirmed by surface chemical composition analysis using X-ray photoelectron spectroscopy, surface topography analysis by atomic force microscopy, and scanning electron microscopy. The acetaldehyde plasma polymer-coated and polyethyleneimine-grafted substrates promoted human umbilical vein endothelial cells attachment, spreading and actin filaments/focal adhesions formation. In contrast, carboxymethyl dextran-grafted substrates resisted cell adhesion. These observations demonstrate that the current surface-modified polymer fibers can be used in tissue engineering applications, such as cell patterning substrates or vascular prosthesis development. © 2010 Wiley Periodicals, Inc. 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