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PubMed2004

The tensile properties of tension-free vaginal tape and cadaveric fascia lata in an in vivo rat model.

OBJECTIVE: To examine the tensile properties (break load and maximum average load), after in vivo implantation in a rat animal model, of tension-free vaginal tape (TVT) and cadaveric fascia lata (CFL), as pubovaginal slings of these materials have become popular for treating stress urinary incontinence. MATERIALS AND METHODS: Twenty Sprague-Dawley rats (300-400 g) had 1 x 2 cm strips of commercially available TVT and CFL implanted on the right and left anterior abdominal wall, respectively. Half of the animals were then killed at 6 weeks and the remainder at 12 weeks, after which the strips of TVT and CFL were removed and their tensile properties measured using a tensiometer. The tensile strength of TVT and CFL strips maintained only in normal saline served as controls. RESULTS: The TVT strips had a mean break load of 0.740 kg in the control and only 0.390 kg for CFL (P < 0.05). At 6 weeks the TVT material had a mean (sd) maximum average load of 0.634 (0.096) kg and a mean break load of 0.589 (0.249) kg, whereas the respective values for the CFL were 0.323 (0.198) and 0.167 (0.063) kg (P < 0.05). Similarly at 12 weeks, TVT had a greater mean maximum average and break load than CFL, at 0.742 (0.052) and 0.274 (0.126), and 0.737 (0.056) and 0.185 (0.128) kg, respectively. CONCLUSION: This is the first study to assess the tensile properties of the currently used sling materials, TVT and CFL, in an in vivo model. TVT has a greater break load and maximum average load than CFL; the tensile strength of these materials does not decrease with time.

Animals↗
PubMedDate not supplied

Use of autogenous fascia lata graft for perineal herniorrhaphy in dogs.

OBJECTIVE: To evaluate the effectiveness of a herniorrhaphy technique, using an autogenous fascia lata graft (FLG) for perineal hernia (PH) repair in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: Twelve dogs with PH. METHOD: PHs were repaired with FLG harvested from the dog's ipsilateral thigh and sutured directly into the perineal defect. Correction of associated conditions, and castration were performed. Surgical time, pain, inflammation, pattern of defecation, lameness, hospitalization time, postoperative complications, and owner satisfaction were recorded. Histopathologic examination was performed in 1 dog euthanatized 10 months after repair. RESULTS: Hernia did not recur (mean follow-up, 5.8 months). Lameness was the most frequent minor complication, and was resolved within a few days. Transient rectal prolapse occurred in 2 dogs with bilateral PH. The mean (+/-SD) hospitalization was 1.8+/-0.9 days, and the surgical time was 76.5+/-9.8 minutes. Histopathologic examination in 1 dog revealed perfect integration of FLG into adjacent tissues without substantial tissue reaction. CONCLUSIONS: FLG reconstruction of PH is a simple, effective method of treatment. CLINICAL RELEVANCE: FLG can be used without major complications for primary repair of PH, as an augmentation procedure when the internal obturator muscle is thin or friable, or when herniation has recurred after another repair technique.

Animals↗
PubMedDate not supplied

Repair of urethral defects using fascia lata autografts in dogs.

OBJECTIVE: To evaluate the feasibility of urethroplasty using a free fascia lata (FL) graft in the dog. STUDY DESIGN: In vivo experimental study. ANIMALS: Mixed-breed dogs (n=14). METHODS: Half of the circumference of the urethra, approximately 1.5 cm long, was excised in 14 male dogs to induce a urethral defect. FL (approximately 2 cm x 2 cm) harvested from the lateral thigh was sutured to the urethra using a 3-0 polyglactin 910 continuous pattern. Dogs were monitored daily for bladder distention and had urethral catheters until normal voiding was observed. On day 60, each dog had a positive contrast urethrogram, and then 8 dogs were euthanatized for gross and histologic examination. Six dogs were monitored for urologic problems for 6 months, and a positive contrast urethrogram was repeated. RESULTS: All dogs recovered successfully; 4 dogs had difficulty voiding for 2-3 days and urine was aspirated from these dogs every 3 hours until signs of painful urination disappeared. On positive contrast urethrograms, urethral anatomy was considered normal except in 4 dogs that had an irregular contour. Gross urethral examination confirmed an absence of ulceration, stricture, diverticula, or fistula formation, and the FL-lined graft survived in all dogs. No degenerative and reparative responses were observed. On histologic examination of the penile urethra, the lumen was intact, covered with transitional epithelium, and surrounded by corpus spongiosum with cavernous spaces and blood-filled vessels. CONCLUSIONS: Free FL grafts are incorporated satisfactorily and would appear to be useful for repairing urethral defects. CLINICAL RELEVANCE: FL grafts should be considered for repair of urethral defects in dogs.

Animals↗
PubMed2003

Complete patellar ligament replacement using a fascia lata autograft in a dog.

A novel technique for the repair of a chronically lacerated patellar ligament in a pet greyhound is described. The injury had been sustained traumatically, and a previous surgical repair had proved unsuccessful. On further surgical investigation, identification of the ruptured ligament ends was not possible. A double fascia lata graft was employed to reconstruct the lateral and medial portions of the ligament. This repair was augmented with 27 kg monofilament nylon anchored through tunnels from the proximal tibia to the patella and quadriceps tendon. A concurrent skin deficit was managed with a superficial epigastric axial pattern flap. To the authors' knowledge, only one previous case requiring complete patellar ligament replacement has been documented in the veterinary literature. This report details a simplified surgical technique which may have advantages over the previously described technique.

Animals↗
PubMed1984

Strain topography of human tendon and fascia.

Discretized surface strains for human tendon and fascia were photogrammetrically determined with high-speed cinematography and were displayed topographically using three-dimensional computer graphics. Substantial differences were found between estimates of tissue strain measured from grip motion versus discretized strain estimates from high-speed films. The computer-generated contour maps also provide a useful technique for analyzing the nonhomogeneity of tendon and fascial strains during high rate tests.

Adult↗
PubMed1978

Protrusion of the lung apex through Sibson's fascia in infancy.

Apical 'herniation' of the lung is an unusual protrusion of the lung and its pleural coverings through the superior aperture of the thorax. It is supposedly caused by weakness of Sibson's fascia. The phenomenon is an anatomical variation and not a disease entity; however, it must be recognised in order to avoid inappropriate surgery. The condition apparently disappears spontaneously with growth.

Fascia↗
PubMed1981

Abnormalities of the perinephric fascia and fat in pancreatitis.

CT may reveal inflammatory thickening of the retroperitoneal fascial membranes and edema or lipolysis of the retroperitoneal fat resulting from acute pancreatitis. Retrospective analysis of the perinephric space in 16 normal individuals gave values of 1-3 mm for perinephric fascial thickness and -132 to -92 H for perinephric fat density. Scans of 15 patients with pancreatitis demonstrated fascial thickening in 46% compared with 5% of normal individuals, while 27% had increased fat density compared with 6% of the normal population. An abnormal CT appearance of the retroperitoneal fascia or fat can be a sign of pancreatitis.

Acute Disease↗
PubMed1981

Role of fascia in maintenance of muscle tension and pressure.

The effect of fasciotomy on muscle tension (measured by a force transducer attached to the tendon) and interstitial fluid pressure (measured by Wick catheters in the muscle belly) was studied in the anterolateral compartments of 13 dog hindlimbs. Muscle tension and pressure were monitored in the tibialis cranialis muscle after low- and high-frequency stimulation of the peroneal nerve to produce twitch- and tetanic-type contractions. Fasciotomy decreased muscle force during the low-frequency stimulation by 16% (35.3 +/- 4.9 to 28.4 +/- 3.9 N) and during the high-frequency stimulation by 10% (60.8 %/- 4.9 to 54.8 +/- 3.9 N). Muscle pressure decreased 50% after fasciotomy under both conditions, 15 +/- 2 to 6 +/- 1 mmHg and 84 +/- 17 to 41 +/- 8 mmHg), respectively. Repeated functional evaluations during the testing procedure indicated that muscle fatigue was not a major factor in these results. It was concluded that fascia is important in the development of muscle tension and changes in interstitial pressure. Furthermore, the results raised questions concerning the merits of performing a fasciotomy for athletes with a compartment syndrome.

Animals↗
PubMed2001

Cadaver fascia lata sling in the treatment of intrinsic sphincter weakness.

Eight older women with stress incontinence caused by intrinsic urethral weakness underwent sling surgery with allogenic fascia lata. The tolerance of the material was excellent. In 1 case a secondary release of the fixation on the pecten was necessary because of too much tension; in the other cases the evolution was uneventful and resulted in perfect continence lasting for at least 2 years of follow-up.

Aged↗
PubMed2004

Effect of extratesticular hematoma on testicular blood flow and the histology of the testis and dartos fascia. an experimental study.

INTRODUCTION: Hematoma is a common complication of inguinoscrotal surgery in childhood. We aimed to identify the possible effects of extratesticular hematoma on blood flow and the histology of testes in the early period. Also, the dartos tissue was evaluated histologically. MATERIALS AND METHODS: Unilateral extratesticular hematoma was created in 12 New Zealand rabbits. Parenchyma of the testes and scrotum walls was evaluated by B-mode ultrasound and the spectrum from the intratesticular vessels was obtained by color Doppler ultrasound on days 1, 7 and 15 of the procedure. Testes and scrotal walls were removed at the end of the study for histologic evaluation. RESULTS: There were no significant pathologic findings in the evaluation of the parenchyma and hemodynamia of the testes on days 1, 7 and 15. A well-organized but continuing hematoma was observed on day 15. Increased fibroblastic activity, dense inflammatory cells, necrotic areas and destruction of the muscular layer were observed at pathologic evaluation of the scrotum. CONCLUSIONS: Extratesticular hematoma has no effect on testicular histology and hemodynamia in the early period. Pathologic evaluation revealed fibrosis of the dartos fascia at the end of the second week. Destruction and fibrosis of this tissue may have an adverse effect on spermatogenesis by altering thermoregulation.

Animals↗
PubMedDate not supplied

The medial horn and capsulopalpebral fascia in the medial canthus are significant antagonists of the orbicularis oculi muscle for lacrimal drainage.

PURPOSE: The anatomical relationship indicates that the medial horn of the levator aponeurosis (MH) and the capsulopalpebral fascia (CPF) are the potential candidates for antagonists of the orbicularis oculi muscle (OOM). This study sought to disclose the relationships among the MH, CPF and OOM, and to discuss their roles in the lacrimal drainage system. METHODS: Twelve medial canthuses of 6 cadavers were studied. After peeling eyelid skin from the OOM, we carefully observed the MH, CPF and OOM in the medial canthus. RESULTS: The MH attached to the superior aspect of the medial canthal tendon. The CPF, which attached to the lower tarsal margin, traveled just under Horner's muscle in the medial canthus and dispersed from a lateral aspect of the lacrimal sac to the posterior lacrimal crest. CONCLUSIONS: As the movement of a muscle can be determined by its origin and insertion, the MH and the CPF are considered to be the antagonists of the OOM, and as such must be taken into consideration for an understanding of the lacrimal drainage system.

Aged↗
PubMed1994

Vascularized fascia as a transferable bed for experimental laryngeal reconstruction.

Laryngeal defects were reconstructed with a combined vascular flap consisting of lateral thoracic fascia used as a transferable vascular bed. A buccal mucosal graft was fixed on this bed as an internal lining. An autogenous cartilage graft, circumferentially wrapped in vascular connective tissue, was used as external support. The first focus of interest of this experimental study was to investigate the necessity of epithelial lining in the repair of a full-thickness laryngeal wall defect. The second focus of interest was to study reconstruction of the posterior glottis by introducing additional supporting material.

Animals↗
PubMed1985

Tympanomastoid surgery: a technique for repairing posterior osseous canal wall defects with autologous temporalis fascia and bone pâte.

A technique for repairing small to medium-sized defects in the osseous posterior superior canal resulting from pathologic or iatrogenic causes is described. Bone pâte is harvested from the mastoid cortex by means of a simple collection technique. A sandwich graft composed of autologous temporalis fascia lined with bone pâte is used to fill in the canal wall defect. This technique has been used successfully in 27 of 28 cases, with follow-up as long as 8 years. When fully healed, the bone graft has attained the texture and consistency of the normal osseous canal and, if necessary, can be curetted or drilled for reshaping during planned second-stage tympanomastoid surgery. The temporalis fascia/bone pâte graft technique is simple, easy to learn, and has proven to be a reliable method for repairing the defects described.

Ear Canal↗
PubMed2002

Reappraisal of fascia lata grafts for reconstruction of chest wall defects.

Large chest wall defects require surgical reconstruction to ensure structural stability and to prevent flail chest. We used autologous fascia lata grafts to reconstruct skeletal chest wall defects in 8 consecutive patients. Sufficient chest wall stability was obtained; and no complications, such as flail chest, infection, or seroma, have been observed in any of the cases to date.

Fascia Lata↗
PubMedDate not supplied

Spontaneous rupture of the plantar fascia.

In this study, rupture of the plantar fascia was seen in five feet, of which four had had plantar fasciitis. At the time of the injury, which is an acceleration type of motion, there is severe pain in the heel followed by the development of ecchymosis in the sole and toward the heel of the foot. With conservative symptomatic care, the acute symptoms as well as the plantar fasciitis symptoms subside, generally allowing full activity in 3 to 4 weeks.

Adult↗
PubMedDate not supplied

Long-term followup of anterior cruciate ligament reconstruction using freeze-dried fascia lata allografts.

We identified 79 patients who underwent arthroscopically assisted intraarticular anterior cruciate ligament reconstruction with freeze-dried fascia lata allografts and an additional lateral extraarticular reconstruction. We were able to contact 62 patients (79%) for follow-up evaluation at an average of 134.5 months. Forty patients (51%) returned for objective evaluation. Lysholm scores at followup averaged 92.3 and Tegner activity scores averaged 5.1. Only four (6%) of the 62 patients contacted reported episodes of full giving way. Thirty (75%) of the 40 patients examined demonstrated 3 mm or less side-to-side difference on KT-1000 arthrometer manual maximum evaluation. Forty-eight (77%) of the 62 patients were participating in sporting activities at final followup. No patient had evidence of graft rejection.

Adult↗