• 제목/요약/키워드: Surgical mesh

검색결과 75건 처리시간 0.024초

Preliminary evaluation of a three-dimensional, customized, and preformed titanium mesh in peri-implant alveolar bone regeneration

  • Jung, Gyu-Un;Jeon, Jae-Yun;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권4호
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    • pp.181-187
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    • 2014
  • Objectives: The purpose of this preliminary study is to evaluate the effectiveness of a customized, three-dimensional, preformed titanium mesh as a barrier membrane for peri-implant alveolar bone regeneration. Materials and Methods: Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed. Results: Satisfactory bone regeneration with limited fibrous tissue was detected beneath the preformed titanium mesh. Histologic findings revealed that newly formed bones were well-incorporated into the allografts and connective tissue. New growth was composed of approximately 80% vital bone, 5% fibrous marrow tissue, and 15% remaining allograft. All implants were functional without any significant complications. Conclusion: The use of preformed titanium mesh may support bone regeneration by maintaining space for new bone growth through its macro-pores. This preliminary study presents the efficacy of a preformed titanium mesh as a ready-to-use barrier membrane around peri-implant alveolar bone defect. This preformed mesh is also convenient to apply and to remove.

Comparing Complications of Biologic and Synthetic Mesh in Breast Reconstruction: A Systematic Review and Network Meta-Analysis

  • Young-Soo Choi;Hi-Jin You;Tae-Yul Lee;Deok-Woo Kim
    • Archives of Plastic Surgery
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    • 제50권1호
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    • pp.3-9
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    • 2023
  • Background In breast reconstruction, synthetic meshes are frequently used to replace acellular dermal matrix (ADM), since ADM is expensive and often leads to complications. However, there is limited evidence that compares the types of substitutes. This study aimed to compare complications between materials via a network meta-analysis. Methods We systematically reviewed studies reporting any type of complication from 2010 to 2021. The primary outcomes were the proportion of infection, seroma, major complications, or contracture. We classified the intervention into four categories: ADM, absorbable mesh, nonabsorbable mesh, and nothing used. We then performed a network meta-analysis between these categories and estimated the odds ratio with random-effect models. Results Of 603 searched studies through the PubMed, MEDLINE, and Embase databases, following their review by two independent reviewers, 61 studies were included for full-text reading, of which 17 studies were finally included. There was a low risk of bias in the included studies, but only an indirect comparison between absorbable and non-absorbable mesh was possible. Infection was more frequent in ADM but not in the two synthetic mesh groups, namely the absorbable or nonabsorbable types, compared with the nonmesh group. The proportion of seroma in the synthetic mesh group was lower (odds ratio was 0.2 for the absorbable and 0.1 for the nonabsorbable mesh group) than in the ADM group. Proportions of major complications and contractures did not significantly differ between groups. Conclusion Compared with ADM, synthetic meshes have low infection and seroma rates. However, more studies concerning aesthetic outcomes and direct comparisons are needed.

A novel technique for placing titanium mesh with porous polyethylene via the endoscopic transnasal approach into the orbit for medial orbital wall fractures

  • Bae, Seong Hwan;Jeong, Dae Kyun;Go, Ju Young;Park, Heeseung;Kim, Joo Hyoung;Lee, Jae Woo;Kang, Taewoo
    • Archives of Plastic Surgery
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    • 제46권5호
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    • pp.421-425
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    • 2019
  • Background The endoscopic transnasal approach is widely used for reconstructing the medial orbital wall by filling it with a silicone sheet or Merocel, but this technique has the disadvantage of retaining the packing for a long time. To overcome this drawback, a method of positioning an absorbable plate in the orbit has been introduced, but there is a risk of defect recurrence after the plate is absorbed. Here, the authors report the results of a novel surgical technique of placing a nonabsorbable titanium mesh with porous polyethylene into the orbit through the endoscopic transnasal approach. Methods Fourteen patients underwent surgery using the endoscopic transnasal approach. Preoperative computed tomography (CT) was used to calculate the size of the bone defect due to the fracture, and the titanium mesh was designed to be shorter than the anteroposterior length of the defect and longer than its height. The titanium mesh was inserted into the orbit under an endoscopic view. The authors then confirmed that the titanium mesh supported the orbital contents by pressing the eyeball and finished the operation. Immediately after surgery, CT results were evaluated. Results Postoperative CT scans confirmed that the titanium mesh was well-inserted and in the correct position. All patients were discharged without any complications. Conclusions We obtained satisfactory results by inserting a titanium mesh with porous polyethylene into the orbit via the transnasal approach endoscopically.

실험적 기관 재건술에 대한 고찰 (Review of Experimental Tracheal Reconstruction)

  • 성숙환;김용희
    • 대한기관식도과학회지
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    • 제7권2호
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    • pp.128-139
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    • 2001
  • The purpose of this study was to review the literatures of experimental tracheal reconstruction. Although there have been significant advancements in the surgical treatment of the long circumferential tracheal injuries, there still has been a difficult problem with high morbidity and mortality. The method for tracheal reconstruction after circumferential resection is preferred end-to-end anastomosis for defects up to 6 cm in length, but larger tracheal defects require the use of tracheal allograft, various artificial prosthesis or autogenous organs. The tracheal allotransplantation has been widely used as there was significantly improved the method of surgical technique, preservation and immunosuppression. But it has been limited by a number of factors such as few donor, limited use of immunosuppressant, delayed revascularization and re-epitheliazation. Experimental studies on the tracheal prosthesis have a long history and they tried to use silicone, polytetrafluoroethylene, polypropylene mesh, Dacron, Marlex mesh, external or internal stents. Other experimental studies were reported the use of autogenous tissues that were cartilage. jejunum, aorta, skin, muscle, periostium or esophagus. But a great variety of these protheses have been resulted unsatisfactory in a significant Proportion of cases. Alternatively, the tissue-engineering technique has showed a new approach to reconstruct trachea and much progress in tissue-engineering bas been made recently. In conclusion, although the tracheal allotransplantation and the use of prosthesis and allograft have been reported a lot of limitation to overcome, we could sooner expect good result of ideal tracheal prosthesis.

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Endoscopic slide-in orbital wall reconstruction for isolated medial blowout fractures

  • Kim, Taewoon;Kim, Baek-Kyu
    • 대한두개안면성형외과학회지
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    • 제21권6호
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    • pp.345-350
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    • 2020
  • Background: This study evaluated the efficacy of the endoscopic medial orbital wall repair by comparing it with the conventional transcaruncular method. This surgical approach differs from the established endoscopic technique in that we push the mesh inside the orbit rather than placing it over the defect. Methods: We retrospectively reviewed 40 patients with isolated medial orbital blowout fractures who underwent medial orbital wall reconstruction. Twenty-six patients underwent endoscopic repair, and 14 patients underwent external repair. All patients had preoperative computed tomography scans taken to determine the defect size. Pre- and postoperative exophthalmometry, operation time, the existence of diplopia, and pain were evaluated and compared between the two methods. We present a case showing our procedure. Results: The operation time was significantly shorter in the endoscopic group (44.7 minutes vs. 73.9 minutes, p= 0.035). The preoperative defect size, enophthalmos correction rate, and pain did not significantly differ between the two groups. All patients with preoperative diplopia, eyeball movement limitation, or enophthalmos had their symptoms resolved, except for one patient who had preexisting strabismus. Conclusion: This study demonstrates that endoscopic medial orbital wall repair is not inferior to the transcaruncular method. The endoscopic approach seems to reduce the operation time, probably because the dissection process is shorter, and no wound repair is needed. Compared to the previous endoscopic method, our method is not complicated, and is more physiological. Larger scale studies should be performed for validation.

개의 피부손상에 대한 전층망상식피술 증례 (Use of the Full-thickness Free Skin Mesh Graft for Reconstruction of Wound in a Dog)

  • 김주호;이종일;이해범;허수영;소경민;고재진;전승기;이철호;김남수
    • 한국임상수의학회지
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    • 제24권2호
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    • pp.280-283
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    • 2007
  • A 6-year-old male dog was referred to Animal Medical Center, Chonbuk National University with large distal extremity abrasion wound to the hind limb by automobile accident. The wound was reconstructed with an autogenous, full-thickness skin mesh graft. The graft was harvested from the ventrolateral abdominal wall and transplanted to the wound. The skin mesh graft survived successfully without any noticeable complications. Successful grafting requires asepsis, an adequately prepared recipient bed through the surgical debridement and lavage, proper harvesting and preparation of the graft. Full-thickness skin mesh graft has lesser skin contraction which prevents formation of scar. Meshing the graft provides more graft flexibility over uneven, convex and concave surfaces and allows adequate drainage. The full-thickness skin mesh graft can be successfully used for the treatment of large distal skin wounds in dogs.

Titanium Micro-mesh의 개형을 통한 하벽부 안와골절의 재건 (The Inferior Orbital Wall Reconstruction by Titanium Micro-mesh Remodeling)

  • 김한구;최민석;김우섭;배태희
    • 대한두개안면성형외과학회지
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    • 제10권2호
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    • pp.81-85
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    • 2009
  • Purpose: The inferior orbital wall is the most vulnerable to injury and inadequate reconstruction of inferior orbital fracture result in postoperative complications include enophthalmos, ocular dystopia and diplopia. Although the anatomical reconstruction of the inferior orbital wall is necessary to prevent these complications, the complexity of inferior orbital wall makes it difficult. We fabricated and remodeled the titanium micro-mesh plate for the anatomical reconstruction of inferior orbital wall. Methods: Twenty-nine patients with inferior orbital wall blow-out fracture were operated and twelve of them presented large extensive fracture. We intraoperatively fabricated and remodeled the Titanium-micro mesh to angulated lazy S shape similar to contralateral uninjured orbit. The preoperative and postoperative facial CT scan verified the 3-dimensional and anatomical reconstruction of the fractures. The mean follow-up was 19.7 months and postoperative complications was evaluated. Results: All cases showed the exact anatomical reconstruction, but there were minor complications in two cases. one patient had postoperative diplopia until 3months after surgery and the other patient had persistent enophthalmos (2 mm), but no further surgical correction was required. Conclusion: The comprehensive understanding of orbital convexity is the most important factor for anatomical reconstruction of inferior orbital fracture. We could prevent postoperative complications after inferior orbital wall reconstruction by intraoperative fabrication and anatomical remodeling of Titanium micro-mesh.

Polydioxanone mesh를 이용한 구강점막의 조직 공학적 재건 (TISSUE-ENGINEERED RECONSTITUTION OF ORAL MUCOSA USING POLYDIOXANONE MESH)

  • 문선재;주소연;김진;김학용;박정극;차인호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권4호
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    • pp.249-256
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    • 2003
  • The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.

Orbital wall restoring surgery with resorbable mesh plate

  • Joo, Jae Doo;Kang, Dong Hee;Kim, Hyon Surk
    • 대한두개안면성형외과학회지
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    • 제19권4호
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    • pp.264-269
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    • 2018
  • Background: Orbital resorbable mesh plates are adequate to use for isolated floor and medial wall fractures with an intact bony buttress, but are not recommended to use for large orbital wall fractures that need load bearing support. The author previously reported an orbital wall restoring surgery that restored the orbital floor to its prior position through the transnasal approach and maintained temporary extraorbital support with a balloon in the maxillary sinus. Extraorbital support could reduce the load applied on the orbital implants in orbital wall restoring surgery and the use of resorbable implants was considered appropriate for the author's orbital wall restoring technique. Methods: A retrospective review was conducted of 31 patients with pure unilateral orbital floor fractures between May 2014 and May 2018. The patients underwent transnasal restoration of the orbital floor through insertion of a resorbable mesh plate and maintenance of temporary balloon support. The surgical results were evaluated by the Hertel scale and a comparison of preoperative and postoperative orbital volume ratio (OVR) values. Results: The OVR decreased significantly, by an average of 6.01% (p<0.05) and the preoperative and postoperative Hertel scale measurements decreased by an average of 0.34 mm with statistical significance (p<0.05). No complications such as buckling or sagging of the implant occurred among the 31 patients. Conclusion: The use of resorbable mesh plate in orbital floor restoration surgery is an effective and safe technique that can reduce implant deformation or complications deriving from the residual permanent implant.

Reconstruction of Triceps Tendon Avulsion Using Mesh Graft and Krackow Suture in a Border Collie

  • Hyeon-Jong Choi;Jong-Hoon Kim;Eunchae Yoon;Tae-Sung Hwang;Hee-Chun Lee;Dongbin Lee;Jae-Hoon Lee
    • 한국임상수의학회지
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    • 제39권6호
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    • pp.378-383
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    • 2022
  • A 3-year-old, 24-kg intact female Border Collie was referred for a toe-touch weight-bearing stance, intermittent weight-bearing lameness, and moderate pain reaction of the right forelimb on physical examination and right humerus olecranon avulsion fracture on diagnostic imaging examination. Surgical repair was performed using tension band wiring to re-attach the triceps tendon and distal olecranon. Migration of the distal olecranon fragment was observed due to comminuted fracture of the fragment 5-days after surgery, and revision surgery was performed. The tension-relieving sutures were passed through the pre-drilled hole in the olecranon, and the polyester mesh was augmented to the suture region, covering the triceps tendon and olecranon drilling hole using the Krackow suture pattern. The elbow joint was immobilized using a type IA transarticular external fixator, which was removed 8 weeks after surgery. Fourteen weeks after surgery, no lameness was observed on gait evaluation. At follow-up after 7 months, the distal olecranon fragment had stabilized, and no lameness was observed.