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At least 253 records · Page 14Linked to original sources
PubMed2003

Differences in the quantity of elastic fibres and collagen type I and type III in endopelvic fascia between women with stress urinary incontinence and controls.

The aim of this study was to evaluate whether differences in the quantity of elastic fibres, collagen type I and collagen type III in the endopelvic fascia occur with female stress urinary incontinence (SUI). A total of 54 patients participated in the study. They were divided into two groups (continent and incontinent) that were comparable with respect to age and parity. All patients underwent gynaecologic surgical procedures and biopsies from the endopelvic fascia were obtained. Histological slides were stained with haematoxylin and eosin and Masson trichrome or Weigert's techniques and immunohistochemistry for either collagen type I or type III were performed. The elastic fibres constituted 3.81+/-0.6% and 5.93+/-0.92% of the cross-sectional area of the endopelvic fascia in incontinent and control groups of patients, respectively. Collagen type I and type III were not significantly reduced in patients with SUI. Our results suggest that the quantity of elastic and collagen fibres in the endopelvic fascia does not play a significant role in continence.

Adult↗
PubMed2002

The use of cervical fascia for hypopharyngeal reconstruction with laryngeal preservation.

Surgical resection of carcinomas of the posterior hypopharyngeal wall and reconstruction of defects with preservation of laryngeal function and swallowing are complex surgical problems. The various reconstructive procedures have been well described. There is no uniform agreement among surgeons as to which of the most frequently used techniques offers the best results. We use the cervical fascia in a new method for reconstruction of the posterior hypopharyngeal wall after carcinoma resection with preservation of laryngeal functions. Reconstruction with the fascia flap was used in eight selected patients. The surgical technique is easy and oncologically safe, with a short operative time and low complication rate. The cervical fascia proved to be good quality biological material for the reconstruction of two-dimensional defects. Functional results of swallowing, respiration and phonation have been satisfactory. Based on our experience and good results using the cervical fascia flap, this method has proven to be very beneficial in select patients with carcinoma of the posterior wall of the hypopharynx.

Aged↗
PubMed2004

Abdominal musculature and the transversalis fascia: an anatomical viewpoint.

This anatomical study investigated the connection of the muscles of the abdominal wall to the transversalis fascia in the groin. In six unfixed male corpses we prepared the single levels of the inguinal abdominal wall and examined their interrelationships. Of special interest were the direction of the force vectors determined by the direction of the muscular fibers in relation to the transversalis fascia. We found no confirmation of a direct connection between the muscles of the abdominal wall and the transversalis fascia in the inguinal region. No force vector of the different muscular layers points away from the triangle of Hesselbach. By contraction each muscle thus relaxes the transversalis fascia of the Hesselbach triangle.

Abdominal Muscles↗
PubMed2005

Abdominal sacral colpopexy with allograft fascia lata: one-year outcomes.

OBJECTIVE: The purpose of this study was to assess 1-year outcomes of sacral colpopexy with the use of allograft fascia lata. STUDY DESIGN: Records of all subjects who underwent sacral colpopexy with allograft fascia lata from May 1, 2001, to April 30, 2003, were reviewed. Subjects underwent pre- and postoperative evaluation of prolapse with the pelvic organ prolapse quantification system. The Fisher's exact test was used to analyze the results. RESULTS: Allograft fascia lata was used for 24 colpopexies during this period. No significant intraoperative or postoperative complications or graft erosions occurred. Five subjects were lost to follow-up after 3 months. Analysis was performed on the remaining 19 subjects. Prolapse of stage 2 or more in compartments Aa, Ba, Ap, Bp, and C was preoperatively 50%, 74%, 78%, 84%, and 68% and postoperatively 11%, 16%, 21%, 26%, and 5%, respectively. CONCLUSION: Allograft fascia lata may be a suitable alternative to permanent mesh for sacral colpopexy, but longer-term outcomes and larger studies are needed.

Adult↗
PubMed2005

Terminologia Anatomica versus unofficial descriptions and nomenclature of the fasciae and ligaments of the female pelvis: a dissection-based comparative study.

OBJECTIVE: The aims of this study were: (1) to define and classify those connective structures of the female pelvis that are of potential clinical interest, (2) to evaluate the adequacy of the Terminologia Anatomica (official nomenclature) and (3) to establish a correspondence between the official nomenclature and the most commonly used terms. STUDY DESIGN: The results of 30 macroscopic and laparoscopic dissections of fresh cadavers with and without vessel injection of colored latex solutions were compared with the descriptions and definitions in the Terminologia Anatomica and the most frequently cited English and non-English literature from 1890 to 2003. RESULTS: We identified 3 groups of fasciae, parietal pelvic fascia, visceral pelvic fascia, and extraserosal pelvic fascia, which could be divided into diverse clinically relevant anatomical structures characterized by different locations, spatial orientation, and consistency. These structures differed considerably with regard to number and nomenclature from those described in the Terminologia Anatomica and part of the literature. CONCLUSION: Our results suggest that the official terminology applied to the connective structures of the female pelvis could be profitably revised and expanded. We offer a complete description of these structures and suggest a classification that may be useful for teaching and clinical purposes.

Aged↗
PubMed2004

Banked cadaveric fascia lata: 3-year follow-up.

Autologous fascial and synthetic materials have been widely used to repair the stress form of urinary incontinence (SUI) as well as pelvic floor prolapse. The safety and long-term durability of cadaveric fascia lata in orthopedic and ophthalmologic surgery have encouraged urogynecologists to use this material for a sling material. The rationale of placement of a sling from cadaveric fascia lata is based upon decreasing the complication rates caused by autologous and synthetic materials. However, the high costs of the commercially available tissues in Brazil have limited its use in public health. In our institution we developed a cadaveric fascia lata bank, harvesting the material according to the Brazilian Transplantation Legislation and storing it at -70 degrees C. The safety of the tissue is achieved by 25-kGy irradiation. Since 1999, 30 patients have undergone surgery using material from five donors in repairs for stress urinary incontinence and pelvic floor prolapse at a mean of 34 months' follow-up (ranging from 30 to 40 months), there was no evidence of rejection. Therefore, we have shown the safety of cadaveric fascia lata harvested and treated as described above in our group of patients.

Cadaver↗
PubMed2003

Fascia lata grafts for closure of secondary urethral fistulas.

OBJECTIVES: To evaluate the efficacy of fascia lata graft in the repair of secondary urethral fistulas. Urethral fistulas may result from a complication of hypospadias repair. The treatment of urethral fistulas is quite challenging. METHODS: This technique was used in 8 patients between 2000 and 2002. All patients had undergone hypospadias repair and had recurrent fistula formation. A 2 x 2-cm fascia lata graft was harvested from the lateral aspect of the thigh. After repair of the fistula, the fascia lata graft was placed between the urethra and skin. The mean age of the patients was 8 years (range 5 to 13). RESULTS: During 8 to 22 months (average 11) of follow-up, no recurrence of urethral fistula was observed. No complications occurred, and patients were completely satisfied with the results. CONCLUSIONS: The results of this study show that the fascia lata graft can be used for the closure of urethral fistula secondary to hypospadias repair. Additional studies are warranted.

Adolescent↗
PubMed1997

The fascia lata suburethral sling for treating recurrent urinary stress incontinence.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of the fascia lata suburethral sling procedure in the treatment of recurrent genuine urinary stress incontinence. STUDY DESIGN: This study was a retrospective analysis of 60 patients who had a suburethral fascia lata sling placement between January 1992 and December 1995. Follow-up ranged from 6 months to 3.5 years. The database was obtained by a retrospective chart review, a written questionnaire, and telephone interview. RESULTS: Between January 1992 and December 1995, 72 patients who had at least one previous incontinence procedure were assessed by urodynamic testing and cystourethroscopic examination before undergoing a fascia lata sling placement. Of this population, 60 were available for follow-up. Of this 60, 54, or 90%, had complete cure or marked improvement in the urinary incontinence. There were six failures, two of which had no bladder neck mobility and two of which had detrusor instability and were unable to take medication because of medical contraindications. In addition, two slings were sacrificed because of postoperative complications. The most common postoperative complication was urinary retention, which resulted in eight, or 13.4%, of slings needing to be released. CONCLUSION: Our data support the use of the suburethral fascia lata sling as an effective method for the treatment of recurrent genuine urinary stress incontinence, with urinary retention being the most common postoperative complication.

Adult↗
PubMed1999

Functional failure of fascia lata allografts.

OBJECTIVES: Fascia lata allografts are commonly used in urogynecologic procedures. Functional failure of several grafts has occurred, and such failure has been recognized as a materials problem in 12 patients. STUDY DESIGN: Twelve patients with failure of an initial urogynecologic procedure performed with irradiated and freeze-dried donor fascia lata grafts underwent reoperation. Portions of the implanted fascia lata grafts could be retrieved in 7 cases. Graft specimens underwent histologic processing followed by hematoxylin and eosin staining. RESULTS: Histopathologic analyses of the retrieved material demonstrated several ongoing processes in the failed grafts. A few grafts showed areas of ideal remodeling. Most grafts, however, showed areas of disorganized remodeling and areas of graft degeneration. Evidence of immune reaction to the graft was observed in some cases. CONCLUSION: The high materials failure rate associated with the use of irradiated and freeze-dried donor fascia lata grafts suggests that such tissue should not be used for urogynecologic procedures.

Fascia Lata↗
PubMed2001

Use of cadaveric solvent-dehydrated fascia lata for cystocele repair--preliminary results.

OBJECTIVES: To present a surgical technique in which cadaveric fascia lata is used for cystocele repair. METHODS: Twenty-one consecutive women (mean age 67 +/- 10 years) with severe cystocele were prospectively enrolled. All patients underwent meticulous clinical and urodynamic preoperative evaluations. Solvent-dehydrated, Tutoplast-processed, cadaveric fascia lata was used for cystocele repair. The fascia was anchored transversally between the bilateral arcus tendineus and the cardinal and uterosacral ligaments. Standard endopelvic plication was performed thereafter as a second layer. Patients with overt or occult sphincteric incontinence underwent concomitant pubovaginal sling (PVS) surgery as well, using the same material. The main outcome measures included recurrent urogenital prolapse, persistent or de novo urinary incontinence (stress or urge), and dyspareunia. RESULTS: Of the 21 patients, 19 underwent concomitant PVS, 3 concomitant vaginal hysterectomy, and 8 posterior colporrhaphy in addition to their cystocele repair. The mean follow-up was 20.1 +/- 6.7 months (range 12 to 30). No postoperative complications related to the material or technique occurred. None of the patients developed a recurrent cystocele. Two patients (9%), one of whom underwent concomitant posterior colporrhaphy, developed mild recto-enterocele at 4 to 6 months postoperatively. Six patients underwent concomitant PVS for occult sphincteric incontinence. None developed postoperative stress incontinence. Thirteen other patients underwent concomitant PVS for overt sphincteric incontinence. All but two were stress-continent postoperatively. One half of the patients with preoperative urge or mixed incontinence had persistent urge incontinence postoperatively. None of the patients developed postoperative de novo urge incontinence or dyspareunia. CONCLUSIONS: The use of solvent-dehydrated cadaveric fascia lata for cystocele repair, as well as PVS, is associated with encouraging short and medium-term results. Long-term follow-up is needed to evaluate whether these results are durable.

Aged↗
PubMed1996

Fascia lata patch graft in glaucoma tube surgery.

PURPOSE: To determine if using human cadaveric fascia lata grafts to cover glaucoma implant tubes is safe and effective. METHODS: All patients who underwent glaucoma implant surgery at the Doheny Eye Institute between July 1993 and September 1993 received a fascia lata patch graft to cover the subconjunctival portion of the tube. These patients were followed prospectively for clinical signs of conjunctival breakdown, graft melt, tube erosion, graft-related inflammation, infection, and graft-related complications. RESULTS: Twenty-two eyes of 21 patients were followed for a mean of 19 months. All eyes tolerated the fascia lata grafts well without clinical evidence of graft-related conjunctival, scleral, or intraocular inflammation. No tube erosion or melting of the graft was observed in the study group. CONCLUSION: Preserved donor fascia lata was well tolerated as a grafting material in glaucoma implant surgery. No clinical signs of graft rejection, foreign body reaction, tube erosion, or graft melt were observed in the study group during the follow-up period.

Adolescent↗
PubMed1980

The fascia in systemic scleroderma.

Diffuse fasciitis (DF) shares clinical and pathologic features with systemic (SS) and localized scleroderma. The distinct pathologic feature in DF is involvement of the deep fascia, but it is not known if these changes consistently occur in SS. In this study, ten patients with SS underwent deep biopsies for evaluation of the fascia. All cases showed typical dermal histologic findings of scleroderma, and five cases showed thickening and fibrosis of the fascia. This study provides evidence that fascial involvement is not distinctive of DF but may occur in SS. It appears that thickening of the fascia is another morphologic feature shared between DF and SS.

Adult↗
PubMed1997

Reconstruction of the orbital floor with lyophilized tensor fascia lata.

PURPOSE: This article describes the results of using lyophilized tensor fascia lata for the repair of orbital floor defects. PATIENTS AND METHODS: During a 2-year period, orbital floor reconstruction was performed in 12 patients using lyophilized tensor fascia lata. A Foley catheter was placed into maxillary sinus and left in place for 10 days to provide temporary support for the fascia. RESULTS: Patients were followed for 12 months to 2 years. No cases of infection, exposure, extrusion, or graft removal were encountered, and enophthalmus, symmetry changes, or restricted movement were not observed during the follow-up period. CONCLUSION: Lyophilized fascia lata is easy to shape and place in the defect. It provides an excellent material for repair of small to moderate-sized orbital floor defects.

Bone Transplantation↗
PubMed1981

Results of animal experiments on the transplantability of Cialit preserved human fascia.

Results of animal experiments on the transplantability of Cialit preserved fascia are presented. Preserved human fascia was grafted to the area of the forehead of 11 rabbits. Specimens were taken for examination between the 10th and 50th day. The fascia healed normally and was revascularised. Based on the results of these experiments, the method of preserving connective tissue (fascia) in Cialit also appears to be suitable for clinical use in the maxillo-facial region in reconstructive surgery, e.g., in facial palsy.

Adolescent↗
PubMed2002

Is diminished pubocervical fascia collagen content a risk factor for failure of surgical management of genuine stress urinary incontinence in women?

OBJECTIVE: The assessment of relationship between pubocervical collagen content and clinical results of surgical treatment of genuine stress urinary incontinence (GSUI) in women. METHODS: Twenty-four women treated for genuine stress urinary incontinence were included into the study. All women underwent the same surgical procedure. The samples of pubocervical fascia were taken at the time of surgery. The contents of acid soluble, pepsin soluble, insoluble fraction of collagen, total collagen and collagen crosslinks were measured. The study of pubocervical fascia collagen metabolism included also estimation of collagenase activity. At follow-up done 5 years following surgery, 20 patients reported symptoms of GSUI (study group). Four women were still without symptoms of urine leakage (control group). RESULTS: The biochemical parameters of pubocervical fascia did not show, statistically significant differences between compared groups. CONCLUSION: The pubocervical fascia collagen metabolism does not have impact on the results of anti-incontinence surgery.

Cervix Uteri↗
PubMed1977

Enzymes of glucose metabolism in palmar fascia and Dupuytren's contracture.

Several enzymes participating in glucose metabolism and some of the acid hydrolases were assayed in palmar fascia and Dupuytren's contracture with fluorometric microanalytical methods. The enzyme activities of glucose metabolism were lower in normal palmar fascia than in dermis. The fascia of Dupuytren's contracture exhibited a general increase in the enzyme activities of glucose catabolism. Little alteration was found in alanine aminotransferase and UDP-glucose dehydrogenase activity in the lesion. Lysosomal hydrolytic enzyme activities were increased five to ten times in Dupuytren's tissue. The dermis overlying Dupuytren's contracture exhibited an increase in the enzyme activities of glucose catabolism, but to a lesser degree than did the fascia of the lesion. The epidermis of involved palmar skin displayed normal enzyme activities.

Acid Phosphatase↗
PubMed1998

The effect of shear stress on fibroblasts derived from Dupuytren's tissue and normal palmar fascia.

This study examines the real-time intracellular calcium changes of palmar fascia from normal and Dupuytren's diseased fibroblasts in response to shear stress. The real-time cytosolic calcium changes were measured using fluorescence microscopy image processing. The preconfluent primary cultured cells were exposed to 1 minute of flow at 25 dyne/cm2 after a 2-minute baseline of no flow. Additionally, the cells were exposed to an influx of Hank's buffered saline solution with 2% newborn bovine serum to examine the response to serum-born (chemical) agonists. Cytosolic calcium changes were measured as the percentage change over the 2-minute baseline of the mean [Ca2+]i peak. The mean change of the peak [Ca2+]i response of the normal palmar fascia was significantly greater than that of the cells from the Dupuytren's nodular and perinodular tissue. The response to the chemical agonist showed a robust but not statistically different response between the 3 cell types. Our work supports the hypothesis that palmar fascia responds to mechanical stress, specifically laminar fluid flow. These findings may help to explain that an underlying abnormality in the cells of the palmar fascia may be expressed by exposure to laminar fluid flow, a physical signal, rather than a chemical agonist.

Adult↗
PubMedDate not supplied

Assessment of collagen deposits after implant of fascia lata and fat in the vocal folds of rabbits: histomorphometric study.

UNLABELLED: Several materials have been injected or introduced in the vocal folds in attempt of solving the glottic insufficiency. However, few studies have evaluated the cicatricial process due to the implantation of these materials. AIM: The objective of this research was to evaluate the concentration of collagen after microsurgery graft of muscular fascia and fat in the vocal folds of rabbit. STUDY DESIGN: experimental. MATERIAL AND METHOD: Nineteen rabbits were submitted to the graft insert in the right vocal fold, being nine of fascia and ten of fat. The left vocal fold was submitted to the same process, except for the insertion of fat or fascial graft. The rabbits were sacrificed after 90 and 180 days. The collagen was analyzed through the method of the Picrosirius-polarization using the Image Pro Plus software. RESULTS: There was prevalence of the collagen in all grafted groups when compared with the group control. The concentration of the collagen found in the rabbits submitted to fat graft was significantly larger when compared to the concentration of the rabbits submitted to graft of muscular fascia, either with 90 as with 180 days. CONCLUSION: The fat and muscular fascia implantation in the vocal folds of rabbit promoted production of collagen, being more intense with fat.

Adipose Tissue↗