ABSTRACT Background Dural repair products are evolving from animal tissue derived materials to synthetic materials as well as from inert to absorbable features. Biomimicry inspired design will significantly improve growth and regeneration of dural cells and tissues for better repair effects and less complications. We have firstly developed the new absorbable Poly-Llactide (PLLA) dural [...]
The expanded endonasal approach provides access to the entire ventral skull base for resection of neoplasms involving the skull base and brain. The creation of large defects of the bone and dura endoscopically presents unique reconstructive challenges. A layered reconstruction of the dura with inlay and onlay fascial grafts covered with fat grafts is [...]
Abstract Background: We evaluated in a canine duraplasty model how specific differences in device physicomechanical properties, porosity, and crosslinking influenced the biological performance of three processed collagen dural substitutes. Methods: Three collagen dural substitutes were studied: Dura-Guard, DuraGen, and Durepair. The initial strength, stiffness, and suture retention force were measured using standard mechanical test [...]
OBJECTIVE: The need to repair dural defects has prompted the use of dura mater substitutes. Many synthetic materials have been used for dural closure. Neuro-Patch (B. Braun Médical S.A., Boulogne, France) is a nonabsorbable microporous fleece composed of polyester urethane that has been approved for human use by the European Union since 1995. To [...]
Setting One of the consequences of the widespread use of endoscopic endonasal approaches (EEA) to skull base pathologies is the management of complex skull base defects. Nowadays, the gold standard is a multilayer closure that reproduces the physiological tissue barriers. Several techniques have been described in the literature; however, skull base reconstruction after EEA [...]
Postsurgical intra-abdominal adhesions cause significant morbidity and mortality, with small bowel obstruction being the most common complication. The urge to prevent adhesion formation has resulted in multiple experimental and clinical trials and the development of numerous antiadhesive agents. Through the years, hyaluronan-based antiadhesives have proved to be successful in the reduction of adhesion formation. [...]
The purpose of this article is to review progress in the field of abdominopelvic adhesions and the validity of its two underlying assumptions: (1) The formation of adhesions results in infertility, bowel obstruction, or other complications. Reducing or avoiding adhesions will curb these sequelae. (2) ‘‘Adhesions’’ is a monolithic entity to be tackled without [...]
Consequences and complications of postsurgical intraabdominal adhesion formation not including small bowel obstruction and secondary infertility are substantial but are under-exposed in the literature. Inadvertent enterotomy during reopening of the abdomen or subsequent adhesion dissection is a feared complication of surgery after previous laparotomy. The incidence can be as high as 20% in open [...]
The SurgiWrap® MAST Bioresorbable Sheet is a valuable new addition to the armamentarium of gynecologic surgeons. Introduced in the United States in 2001, this polymeric sheet has many uses in both open and laparoscopic procedures, providing temporary wound support and reinforcing weakened soft tissues (Figures 1 through 4). Most important, this bioresorbable sheet creates [...]
The number of bariatric procedures has grown exponentially over the past few years. In the year 2000, 40,000 procedures were performed; 80,000 were performed in 2002; 100,000 procedures were performed in 2003;1 and it is estimated that 140,000 bariatric procedures were performed in 2004.2 Bariatric surgery, including Roux-en-Y gastric bypass, gastric restrictive procedures, laparoscopic [...]