Outpatient Surgery Magazine

Post Your Prices Online - September 2013 - Outpatient Surgery Magazine - Subscribe

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/168873

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Page 121 of 154

OSE_1309_part2_Layout 1 9/6/13 12:24 PM Page 122 A B D O M I N A L S U R G E R Y MIND YOUR MESH Coatings Effective Against Adhesions C oated surgical meshes tend to reduce the incidence of adhesions, regardless of the type of coating with which they've been fortified, say Dutch researchers in the June 2013 issue of the journal Surgical Endoscopy (tinyurl.com/qd3sdsp). In an animal study conducted at Maastricht University Medical Centre in the Netherlands, they compared laparoscopic incisional hernia repair outcomes after using polypropylene meshes coated with absorbable collagen, absorbable omega-3 fatty acids, absorbable cellulose and nonabsorbable PTFE, polyester mesh coated with absorbable collagen, uncoated polypropylene mesh and uncoated collagen mesh. While the coated meshes (and the uncoated collagen mesh) performed similarly well in reducing incidents of adhesions, the uncoated polypropylene performed much less well. "The physical presence of a layered coating between the intraperitoneal content and the abdominal wall," concluded the researchers, "seems to be more important than the chemical properties of the coating in adhesion formation." — David Bernard 1 2 2 option in the eyes of clinical authorities. When I started my residency in the 1980s, we were encouraged not to use mesh — in fact, it was nearly heretical to — and advised to sew up defects with suture instead. To be fair, the conventional wisdom of the time wasn't entirely unwarranted. As a foreign object, mesh has the potential to cause damage in the area it's intended to treat. Even when implanted correctly, it can cause foreign body reactions, pain, infection, adhesions, bowel ingrowth and other complications. With time, with refined techniques and with observation, however, abdominal O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2013

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