Entity

Time filter

Source Type

Norderstedt, Germany

Konerding M.A.,Johannes Gutenberg University Mainz | Chantereau P.,Johnson and Johnson MEDICAL GmbH | Delventhal V.,Johannes Gutenberg University Mainz | Holste J.-L.,Johnson and Johnson MEDICAL GmbH | Ackermann M.,Johannes Gutenberg University Mainz
Medical Engineering and Physics | Year: 2012

Background: An ideal prosthetic mesh for incisional hernia repair should mimic the anisotropic compliance of the abdominal wall, and at lower loads should exhibit higher distensibility without impairment of safety at higher loads. This study evaluated the biomechanical properties of six meshes in a rabbit model. Methods: New Zealand white rabbits were used for this study. Two meshes of the same brand (Ethicon Physiomesh™, Bard Composix® L/P, Gore Dualmesh®, Bard Sepramesh®, Ethicon Proceed® or Parietex™ Composite) were implanted into each animal for assessment of intra-abdominal hernia repair, with a total of ten meshes per group. Twelve weeks after implantation, the abdominal walls with ingrown meshes were harvested and examined biomechanically with a plunger test. The mesh-tissue compliance was evaluated by the forces exerted at given displacements and also described through a simple mathematical approximation. Abdominal wall samples were collected for histopathology, cell turnover and morphometry. Results: No mesh-related complications were seen. The adhesion score was significantly higher in Bard Composix® L/P and Ethicon Proceed® meshes. Significant shrinkage was seen in Gore Dualmesh® and Parietex™ Composite meshes. Physiomesh™ exhibited the highest compliance during plunger testing, characterized by lower, more physiological reaction forces against tissue displacement than the competitor meshes. In contrast, the safety modulus was comparable in all groups. Histology showed less collagen and less foreign body reaction in the Physiomesh™ samples contributing to patient's comfort. Conclusion: In terms of safety, this study showed no superiority of any single mesh. The comfort modulus however differed, being lowest in the newly developed Physiomesh™. © 2011 IPEM. Source


Shapiro L.,U.S. Biotest Inc. | Holste J.-L.,Johnson and Johnson MEDICAL GmbH | Muench T.,ETHICON,Inc. | diZerega G.,U.S. Biotest Inc. | diZerega G.,University of Southern California
International Journal of Surgery | Year: 2015

Purpose: Peritoneal tissue healing is characterized by the simultaneous repopulation of mesothelial cells and the formation of neoperitoneum. Despite the common use of mesh products for abdominal wall repair, there are few investigations of how these materials may impact the peritoneal healing process. Here, we utilized an animal model of abdominal trauma to specifically investigate the peritoneal healing process in conjunction with a composite (poliglecaprone 25-coated polypropylene) mesh. Methods: Abdominal wall injury was simulated in New Zealand White rabbits and peritoneal tissue was covered with composite mesh and fixed with peripheral sutures. Animals were sacrificed at regular intervals (up to 28 days) for macroscopic and microscopic evaluation. Results: Mesothelial cells were consistently identified on the surface of the central areas of the implanted mesh as early as 3-5 days after implantation. From day 7 onward, the entire mesh surface was covered by neoperitoneum which matured over the remaining study intervals. Fibroblast ingrowth of the mesh was apparent by day 5 and increased over time, concurrent with fragmentation of the film on the composite mesh. Conclusions: These results suggest that composite mesh products used for abdominal wall repair do not significantly delay mesothelial repopulation. Study results also support the hypothesis that mesothelial cells involved in healing are derived, at least in part in this model, from free-floating precursor cells located within the peritoneal cavity. © 2015 The Authors. Source


Trzewik J.,Johnson and Johnson MEDICAL GmbH | Holste J.,Johnson and Johnson MEDICAL GmbH | Batke B.,Johnson and Johnson MEDICAL GmbH | Konerding M.A.,Johannes Gutenberg University Mainz | Wolloscheck T.,Johannes Gutenberg University Mainz
Journal of Biomechanics | Year: 2011

Force-elongation responses of the human abdominal wall in the linea alba region were determined by tensile tests in which the linea alba was seen to exhibit a nonlinear elastic, anisotropic behavior as is frequently observed in soft biological tissues. In addition, the geometry of the abdominal wall was determined, based on MRI data. The geometry can be specified by principal radii of curvature in longitudinal of approximately 470. mm and in the transverse direction of about 200. mm. The determined radii agree with values found in other studies. Mechanical stresses, deformations and abdominal pressures for load cases above 6% elongation can be related using Laplace's formula and our constitutive and geometrical findings. Results from uni- and biaxial tensile tests can thus be compared using this model. Calculations confirm that abdominal pressures of approximately 20. kPa correspond to related biaxial forces of about 3.4. N/mm in the transverse and 1.5. N/mm in the longitudinal direction. Young's moduli can be calculated with respect to the uniaxial as well as the biaxial loading. At these physiological loadings, a compliance ratio of about 2:1 between the longitudinal and transversal directions is found. Young's moduli of about 50. kPa occur in transversal direction and of about 20. kPa in longitudinal direction at transverse and longitudinal strains both in the order of 6%. These findings coincide with results from other investigations in which the properties of the abdominal wall have been examined. © 2010 Elsevier Ltd. Source


Konerding M.A.,Johannes Gutenberg University Mainz | Bohn M.,Johannes Gutenberg University Mainz | Wolloscheck T.,Johannes Gutenberg University Mainz | Batke B.,Johnson and Johnson MEDICAL GmbH | And 3 more authors.
Medical Engineering and Physics | Year: 2011

Incisional hernias following median laparotomy have a high incidence and recurrence rate after repair, so that a better understanding of the linea alba biomechanics is desirable. The mechanical stress exerted on the linea alba in living humans is primarily generated by the musculature. In this human cadaver study, intraabdominal pressure was simulated by insertion of a balloon that was increasingly filled to maximal pressures of 200. mbar. The related forces acting transversely on the linea alba at maximum pressure were found to be between 41.6 and 52.2. N/cm (mean = 45.9. N/cm), which is in agreement with a recent modeling of the related forces. © 2011 IPEM. Source

Discover hidden collaborations