Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001511 (Adhesion)
 5,955 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A large abdominal wall hernia, not amenable to primary closure, may require insertion of a prosthesis. The ideal prosthesis maintains strength, is incorporated by surrounding tissues, and does not stimulate adhesions. These qualities vary among available synthetic prostheses. We tested tensile strength, bursting strength, and adhesion formation in response to six materials used in repair of abdominal wall hernias. Adult Sprague-Dawley rats (196) were randomly divided into a control group and six experimental groups. A 4 by 4 cm full-thickness resection of abdominal wall was closed with patches of polypropylene mesh (Marlex), polyglactin 910 mesh (Vicryl), expanded polytetrafluoroethylene (Gore-tex), Dacron-reinforced silicone rubber (Silastic), preserved human dura (PHD), or polypropylene mesh overlying gelatin film (Marlex and Gelfilm, respectively). In controls the 4 cm longitudinal full-thickness incisions were closed primarily. Seven rats randomly selected from each group were sacrificed after 1, 2, 4, and 8 weeks; bursting and tensile strength (tensiometer) and adhesion formation were assessed. There were no differences in bursting strength among the experimental groups at each testing period. Although bursting strength increased linearly with time it was significantly weaker than in controls at 1 and 8 weeks (P less than 0.05). Tensiometric data were inconclusive due to wide variability within the experimental groups. Adhesion formation was moderate to maximal at all evaluation periods for Marlex and Gore-tex. Early adhesion formation was minimal to moderate for both PHD and Vicryl, but later increased with PHD and decreased with Vicryl as this prosthesis was absorbed. No adhesions formed with Marlex and Gelfilm until the gelatin dissolved (1 week), after which the adhesion response was similar to that with Marlex alone. No adhesions formed after Silastic implantation, but graft extrusion and evisceration were common (75%). Controls had no adhesions at all evaluation periods. Wound strength was similar for all prosthetic materials. Absorbable prosthetic Vicryl provided the best long-term protection against adhesions.
 ...
PMID:A comparison of prosthetic materials used to repair abdominal wall defects. 622 7

The experimental animals were divided into six groups for the following purposes. First, dogs in Group 1 were subjected to laminectomy only to determine the development mechanism of scar tissue surrounding the dura mater and nerve root and to ascertain its effect upon the spinal cord. Next, dogs in Groups 2 to 6 were also subjected to laminectomy, but at the same time various types of interposing membranes were inserted experimentally to prevent adhesion of scar tissue and dura mater and nerve root. In Group 2, Gelfilm was inserted; Group 3, a fibrin membrane; Group 4, Silastic Sheet; Group 5, auto fascia and Group 6, auto fatty tissue. The results are based on findings obtained from 67 mature dogs. The tissue defect created after laminectomy became filled with scar tissue derived from the excised ends of the arch and the dorsal muscles, also representing the cause for adhesion with the dorsal dura mater. Fibrotic tissue extending from the dorsal aspect of the dura mater to the nerve root via the lateral wall joined at the dorsal aspect of the nerve root with the fibrotic tissue extending directly towards the nerve root from the excised ends of the arch. Adhesion between scar tissue and the dura mater of the lateral wall and the nerve root was observed 4 months after surgery. The use of interposed membranes after laminectomy suppresses fibrotic proliferation between the excised ends of the arch and nerve root and also inhibited fibrotic growth along the dorsal aspect to the lateral wall of the dura mater, and the results showed that at 4 months after surgery, inhibition in formation of scar tissue was noted in the dorsal aspect of the nerve root. A slight degree of flattening of the spinal cord was found in the laminectomy only group, but no such flattening could be seen in the fatty tissue transplanted group.
 ...
PMID:[Experimental studies on prevention of adhesion of tissue surrounding dura mater and morphological changes in the spinal cord following laminectomy (author's transl)]. 722 60