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PubMedDate not supplied

Laparoscopic removal of pubovaginal polypropylene tension-free tape slings.

OBJECTIVES: Complications of polypropylene pubovaginal tension-free tape slings (TVT, SPARC, and others), such as erosion into the bladder or chronic pain attributed to the mesh sling are rare events; however, when they occur, it may necessitate removal of the sling. To date, removal through a laparotomy incision or by operative cystoscopy has been the most common approach. We present 5 cases of a laparoscopic approach for removal of polypropylene pubovaginal tension-free tape slings. METHODS: We report 5 cases of laparoscopic removal of TVT mesh. Three were removed for mesh erosion into the bladder, and 2 were removed secondary to the patients having persistent pain and discomfort attributed to the sling. An intraperitoneal approach was used to enter the retropubic space to remove the sling. Dissection was completed with a Harmonic scalpel blade as well as blunt dissection to identify the mesh sling retropubically. Average operating time was 104 minutes. Average blood loss was 70 mL. Average hospital stay was <23 hours. Postoperative courses were uneventful; however, 4 of the 5 patients continue to have urgency and frequency symptoms following sling removal. CONCLUSION: These cases illustrate the use of laparoscopy in the removal of polypropylene pubovaginal tension-free tape slings for bladder erosion or persistent pain, or both, attributed to the sling. Erosion and pain are known complications of polypropylene pubovaginal slings and may cause significant morbidity like persistent detrusor instability or urge incontinence, or both. Patients must be informed of these risks and possible complications before making their decision to undergo surgery.

Adult↗
PubMed1988

Polydioxanone and polypropylene suture material in free internal mammary artery graft anastomoses.

An experimental study with six beagle dogs was conducted to evaluate a new monofilamentous absorbable suturing material--polydioxanone. Free internal mammary artery grafts, 3 cm long, were harvested via a median sternotomy and were implanted as arterial bypasses in femoral arteries (12 end-to-end anastomoses) and as arteriovenous shunts in the carotid artery-contralateral jugular vein position (12 end-to-side anastomoses). Twenty-four anastomoses were made with monofilamentous nonabsorbable suturing material, polypropylene (12 arterial, 12 shunts), to serve as control grafts. At 6 months the grafts and anastomoses were explanted and studied with light and scanning electron microscopes. Macroscopically, the polydioxanone sutures had disappeared. The major histologic finding was the foreign body reaction around the polypropylene sutures. In the electron microscopic study the endothelial line covered the anastomotic site and in the polypropylene anastomoses the suture material was bulging up from the anastomoses. No aneurysms or dilatations were seen. According to this study, polydioxanone is a suitable suturing material for small luminal arterial anastomoses and is superior to polypropylene suturing material because it causes no tissue or other late changes on the flow surfaces.

Animals↗
PubMed1987

Stability of dicloxacillin sodium oral suspension stored in polypropylene syringes.

The stability of dicloxacillin sodium in oral suspension stored in clear polypropylene oral syringes was studied. Commercially available dicloxacillin sodium powder for oral suspension from a single lot was reconstituted according to the manufacturer's instructions and drawn into 5-mL clear polypropylene oral syringes. The syringes were divided into groups and stored at -20, 4, 25, 40, 60 or 80 degrees C. Two additional lots were similarly reconstituted, repackaged, and stored at 80 degrees C only to assess interlot variability. Powder in the original containers was similarly reconstituted according to the manufacturer's instructions, and the containers were divided into groups and stored with the syringes. Immediately after reconstitution and at specified times during storage, three syringes and the original containers at each storage temperature were removed, and their contents were analyzed for dicloxacillin sodium concentration using the Standard USP Iodometric Assay. Dicloxacillin sodium follows a first-order rate of degradation at temperatures of 40, 60, and 80 degrees C. The rate of degradation changes to a zero-order process at temperatures of 25, 4, and -20 degrees C. At all temperatures, degradation occurred more rapidly when the drug was repackaged into unit dose polypropylene oral syringes than in the manufacturer's original container. Dicloxacillin sodium reconstituted from powder as oral suspension and repackaged in clear polypropylene syringes was stable for no longer than 7, 10, and 21 days when stored under ambient, refrigerated, and frozen conditions, respectively.

Administration, Oral↗
PubMed1986

The breakdown of polypropylene in the human eye: is it clinically significant?

Polypropylene intracameral sutures and intraocular lens haptics have been reported to develop cracks after varying lengths of time within the eye. A study of the degradation of a 10-0 polypropylene suture and the absence of noticeable degradation on a 4-0 polypropylene intraocular lens haptic removed five years and three months after implantation is presented. The relationship of the molecular orientation of the polypropylene suture to the clinical significance of its cracks is discussed.

Aged↗
PubMed1994

Occupational asthma due to heated polypropylene.

A 35 year-old nonatopic woman was referred to the hospital for possible work-related asthma. She had worked as an operator, at a plant producing polypropylene bags, for the previous four yrs. Her main complaint was a productive cough with dyspnoea and wheezing, as well as rhinitis over the past 3 yrs. She had been absent from work for 6 months on maternity leave, and had improved greatly. She was on a beta 2-adrenergic agent and had to take it at least four times daily. Baseline spirometry whilst at work showed marked airflow obstruction (forced expiratory volume in one second (FEV1) of 43% predicted (pred). After two months away from work FEV1 improved to 89% pred; provocative concentration of histamine causing a 25% fall in FEV1 (PC20) was 3.6 mg.ml-1 (mild airway hyperresponsiveness). Return to work resulted in a marked deterioration in FEV1, and serial peak expiratory flow (PEFR) values. PC20 was 0.11 mg.ml-1 (severe airway hyperresponsiveness) one week after she had returned to work. Specific inhalation challenges with polypropylene heated to 250 degrees C resulted in a late asthmatic reaction. As formaldehyde is one of the degradation products of heating polypropylene, we exposed her to it for up to 2 h, but we elicited no bronchospastic reaction. We conclude that heated polypropylene should be listed as one of the agents that causes occupational asthma.

Adult↗
PubMed1997

Long-term safety of polypropylene knots under scleral flaps for transsclerally sutured posterior chamber lenses.

PURPOSE: To evaluate the safety of polypropylene knots used in TS-SPCL combined with PK and AV over time. METHOD: A retrospective review of 26 consecutive cases of TS-SPCL by one surgeon (WSVM) with at least 12 months follow-up (mean 26, range 12-62). All patients had a double strand polypropylene knot buried under partial thickness scleral flaps at 2 and 8 o'clock. Knots were rotated into the globe (R) in 10 cases, and could not be buried (N) in 13 cases, and in 3 cases 1 knot was buried. RESULTS: No cases of suture erosion occurred in R or N. One or more polypropylene sutures were visible in 17 patients (8 R, 9 T) at last exam. Twenty-three of 52 knots were rotated into the globe, and 70% of rotated knots were not even visible at the slit lamp at final visit. There was no evidence of conjunctival erosion in any patient. There was no lens dislocation and no endophthalmitis. CONCLUSION: The combination of partial thickness scleral flaps with double strand polypropylene knots reduces the incidence of suture erosion through the conjunctive if knots cannot be rotated into the globe.

Adult↗
PubMed1990

Biocompatibility of a polyether urethane, polypropylene oxide, and a polyether polyester copolymer. A qualitative and quantitative study of three alloplastic tympanic membrane materials in the rat middle ear.

The biocompatibility of porous implants made of Estane 5714 F1 polyether urethane, polypropylene oxide, and a poly(ethylene oxide hydantoin) and poly(tetramethylene terephthalate) segmented polyether polyester copolymer (HPOE/PBT copolymer), which were selected as candidates for an alloplastic tympanic membrane, was assessed after implantation in rat middle ears for periods of up to 1 year. Implantation of the materials led to tissue reactions initially associated with the wound-healing process, whereas after 1 month not only the presence of macrophages and foreign-body giant cells surrounding the implant materials but also implant degradation were characteristic for a foreign-body reaction. Macrophages and foreign-body giant cells dominated the picture of the tissue surrounding polypropylene oxide. The altered morphology of these cells, the persistent infiltration of the implantation sites by exudate cells, and the premature death of five rats in the 1-year group suggest that polypropylene oxide degradation was accompanied by the release of toxic substances. Estane and copolymer degradation did not induce tissue responses reflecting implant toxicity, and tympanic membranes given these alloplasts showed a normal healing pattern. Inclusions in the cytoplasm of macrophages associated with degradation and phagocytosis of all of the polymers under study were found to contain iron, silicon, titanium, and aluminum. Growth of fibrous tissue and bone, the latter into Estane and HPOE/PBT copolymer implants, indicated appropriate implant fixation by tissue, although macrophages and foreign-body giant cells were present as well. Especially the fixation of copolymer by ingrowth of bone seems promising in terms of the amount of bone in the pores and the electron-dense bone/copolymer interface. The latter is indicative for bonding osteogenesis. The HPOE/PBT copolymer is a better candidate for alloplastic tympanic membrane than Estane, and the use of polypropylene oxide cannot be recommended.

Animals↗
PubMed2003

Far-infrared laser measurement of the refractive index of polypropylene.

The refractive index of polypropylene in the far infrared (FIR) is measured by means of a suitably modified laser of a FIR spectrometer. When thin polypropylene films of 12.7-microm nominal thickness are introduced in the optical cavity of a laser at the Brewster angle, the radiation ceases because of the change in the optical path of the laser beam. This change is measured from the displacement of one of the laser mirrors, which is necessary to restore the laser resonance. The refractive index of polypropylene is deduced from this measurement and from the film thickness, as obtained from an independent measurement based in pycnometry. The value obtained for the refractive index is 1.492(15) for the wavelengths between 118.834 and 251.140 microm, for a polypropylene film of 12.71(2)-microm thickness and 0.9049(7) g/cm3 density.

Journal Article↗
PubMed2003

Polypropylene mesh repair of incisional hernia.

OBJECTIVE: The purpose of this study is to report the results of tension-free repair of primary and recurrent incisional hernias using polypropylene (Prolene) mesh. DESIGN: Descriptive Study. PLACE AND DURATION OF STUDY: Combined Military Hospital, Kharian and Pano Aqil from January 1998 to September 2002. SUBJECTS AND METHODS: Twenty-seven patients underwent tension-free repair of primary and recurrent incisional hernias with polypropylene mesh in extrafascial position. Nine of them had recurrent incisional hernias, 02 hernias were irreducible and 01 presented with acute intestinal obstruction. Ten patients had hernias in the midline incision, 04 at paramedian incision and rest of them had hernias on transverse abdominal incisions. RESULTS: The mean age was 43.7 years. The only death occurred in a known cirrhotic presenting with obstructed hernia. Another patient was seen developing seroma and wound infection in one case. No recurrence was seen during the mean follow-up period of 2.2 years. CONCLUSION: The tension-free repair of incisional hernia, with polypropylene mesh in extrafascial position, is safe and easy procedure with acceptable morbidity and no recurrence.

Adult↗
PubMedDate not supplied

Barbed polypropylene sutures for midface elevation: early results.

BACKGROUND: In the past decade, the popularity of minimally invasive procedures for midface rejuvenation has greatly increased. We describe a new technique using percutaneous barbed polypropylene sutures to specifically address midface aging. It can be performed in a closed or open approach, depending on the degree of tissue repositioning required. OBJECTIVE: To determine the efficacy of the barbed polypropylene suture in the elevation of the aging midface and the rate of associated early complications. METHODS: Examination of the results obtained in 44 patients in whom we used the barbed polypropylene suture in a private practice plastic surgery facility. Of these patients, 34 underwent an open-approach and 10 a closed-approach procedure. Attention was focused on improvement of the aging midface, including the infraorbital hollow, lower lid position, nasolabial and melolabial creases, and nasojugal groove. Attention was also focused on improvement of the jowls. RESULTS: All patients demonstrated improvement in the midfacial area and jowls, with minimal complications. CONCLUSION: The suture evaluated in this article provides another technique that can be used by facial plastic surgeons in selected patients to address, in particular, ptosis of the midface.

Equipment Design↗
PubMed1987

Comparison of complement activation by silicone intraocular lenses and polymethylmethacrylate intraocular lenses with polypropylene loops.

Silicone intraocular lenses are undergoing clinical investigation for use in the United States. We compared the ability of silicone intraocular lenses to activate the complement system in human sera with that of polymethylmethacrylate intraocular lenses with polypropylene loops using a radioimmunoassay that measures levels of activated complement fragments. Sera incubated with polymethylmethacrylate lenses with polypropylene loops had higher levels of C3a and C5a, but not C4a, than control sera incubated without intraocular lenses. On the other hand, there were no differences in levels of C3a, C4a, and C5a between sera incubated with silicone lenses and control sera. These results suggest that polymethylmethacrylate lenses with polypropylene loops activate the alternative pathway of complement, while silicone lenses do not.

Complement Activation↗
PubMed1996

Platelet adhesion to novel phospholipid materials: modified phosphatidylcholine covalently immobilized to silica, polypropylene, and PTFE materials.

Based on the premise of achieving blood compatibility through mimicking the chemical constitutents of the biologically insert surface of the unactivated platelet membrane, a process was developed that entails the covalent grafting of modified phosphatidylcholine molecules to materials including silica, polypropylene, and polytetrafluoroethylene (PTFE) polymer films. These materials were characterized using x-ray photoelectron spectroscopy (XPS) and contactangle measurements. The phosphatidylcholine-containing materials (PC materials) were used as substrates in the plateletadhesion assays and were subjected to enzymatic degradation evaluation. Phosphatidylcholine-grafted silica materials do not support platelet adhesion. In addition the number of adherent platelets correlate with the amount of grafted phospholipid present, as indicated by the phosphorus/ carbon ratio obtained by XPS analysis. Platelet adhesion to phosphatidylcholine-grafted polypropylene and PTFE was inhibited 80% and 90%, respectively, when compared with platelet adhesion to unmodified polypropylene and PTFE.

Biocompatible Materials↗
PubMed1997

Use of nonporous polytetrafluoroethylene prosthesis in combination with polypropylene prosthetic abdominal wall implants in prevention of peritoneal adhesions.

One of the drawbacks of using macroporous polypropylene prostheses in the repair of the abdominal wall is the formation of adhesions with the viscera. However, polytetrafluoroethylene (PTFE) has low adhesion formation, although it provides less resistance to traction in the repaired zone. The aim of the present study was to reduce the formation of adhesions to a polypropylene implant Prolene (PL) by introducing a nonporous expanded PTFE layer (Preclude Dura-Substitute) (PR) between the polypropylene prosthesis and the abdominal viscera. The scarring process and resistance to traction in the repaired zone were also evaluated. Thirty-six rabbits were divided into three groups and were treated as follows: group I, a PR patch (7 x 5 cm) was secured to the parietal peritoneum; group II, an abdominal wall defect (7 x 5 cm) was created and repaired using a PL patch; group III, an abdominal wall defect was as in group II and was repaired using a combined PR/PL prosthesis. Specimens were evaluated at 14, 30, 60, and 90 days postimplant for extent of adhesion formation and morphological analysis was performed using light and scanning electron microscopy. Biomechanical resistance of the implant was evaluated using strips comprising prosthetic material and anchorage tissue. Group I and group III prostheses showed loose adhesions only, but group II adhesions were firmly attached. The mean surface areas covered by adhesions were 0.08 cm2 (group I), 7.67 cm2 (group II), and 0.1 cm2 (group III). PR implants (group I) were encapsulated by organized tissue. In group II the formation of disorganized tissue invading the prosthesis was observed. In group III the PR impeded the growth of disorganized scar tissue and the lower surface of the implant was covered by an orderly neoperitoneum. Resistance to traction of the double implants (group III) (mean +/- SD, 33.32 +/- 0.9 N) was similar to that of the Prolene implants (group II) (33.76 +/- 0.46 N) (Mann-Whitney U test, p < 0.05). We concluded the presence of a PR layer between the PL implant and viscera greatly reduced the incidence of adhesion formation without affecting the high resistance to traction provided by the PL implant or the evolution of the scarring process.

Abdominal Muscles↗
PubMed2005

Randomized clinical trial comparing lightweight composite mesh with polyester or polypropylene mesh for incisional hernia repair.

BACKGROUND: Polymer mesh has been used to repair incisional hernias with lower recurrence rates than suture repair. A new generation of mesh has been developed with reduced polypropylene mass and increased pore size. The aim of this study was to compare standard mesh with new lightweight mesh in patients undergoing incisional hernia repair. METHODS: Patients were randomized to receive lightweight composite mesh, or standard polyester or polypropylene mesh. Outcomes were evaluated at 21 days, 4, 12 and 24 months from patient responses to the Short Form 36 (SF-36) and daily activity questionnaires. Complications and recurrence rates were recorded. RESULTS: A total of 165 patients were included in an intention-to-treat analysis (83 lightweight mesh, 82 standard mesh). Postoperative complication rates were similar. The overall hernia recurrence rate was 17 per cent with the lightweight mesh versus 7 per cent with the standard mesh (P = 0.052). There were no differences in SF-36 physical function scores or daily activities between 21 days and 24 months after surgery. CONCLUSION: The use of the lightweight composite mesh for incisional hernia repair had similar outcomes to polypropylene or polyester mesh with the exception of a non-significant trend towards increased hernia recurrence. The latter may be related to technical factors with regard to the specific placement and fixation requirements of lightweight composite mesh.

Activities of Daily Living↗
PubMed1991

Performance of the polypropylene fiber tailstring on the Copper 7 intrauterine device.

New and used polypropylene tailstrings from the Copper 7 (Cu-7) intrauterine device were examined by a combination of analytical techniques. Optical microscopy, scanning acoustic and electron microscopy, x-ray diffraction, energy dispersive x-ray analysis, and chemical etching were employed to elucidate both the surface and interior morphology of new Cu-7 tailstrings. Tailstrings removed from women following varying periods of use were investigated with optical microscopy, scanning and transmission electron microscopy. In addition, a subset of the used tailstrings were cultured to identify the types of microorganisms associated with them. Our findings show that unused Cu-7 tailstrings are in various stages of degradation owing to a combination of factors which include the high-draw ratio employed during manufacturing, the method of packaging, and the use of a particulate colourant. Furthermore, it is evident that used Cu-7 tailstrings undergo major deterioration while in situ because of the unfavorable interactions between the highly drawn polypropylene and the physiological environment. These results indicate that the polypropylene tailstrings as manufactured for use with the Cu-7 IUD fail to meet accepted design criteria for biomedical implants.

Bacterial Infections↗
PubMed2007

Analysis of outcomes of single polypropylene mesh in total pelvic floor reconstruction.

AIMS: A 2.5-year outcome analysis was performed on patients who underwent transvaginal repair of total pelvic organ prolapse with single polypropylene mesh. A description of the repair technique using a tension-free 4-point fixation is also reviewed. METHODS: After proper vaginal dissection, a specially fashioned "H" shaped polypropylene mesh is positioned and fixed at 4-points. With a single piece of mesh, the anterior arms provide mid-urethral and bladder neck support, the mid-portion of the mesh corrects anterior compartment defects, and the posterior arms aid in vaginal vault suspension. Initially, bone anchors were utilized for anterior fixation, but currently a tension-free method is used. A retrospective analysis using chart review was performed on 96 patients who underwent this procedure from January 2000 to June 2005. Additional information was gathered by a telephone survey using a questionnaire. Statistical analysis was performed using Student's t-test, with Sigma Stat(R). RESULTS: Seventy-six patients (79%) were available with a mean follow-up time of 30.7 +/- 1.7 months and mean age of 69.3 +/- 11.3. Among those with follow-up, 36 patients (47.4%) underwent concurrent hysterectomies. Recurrence of prolapse was reported by four patients (5.2%). Sixty-eight patients (89%) were completely dry or almost dry, defined as an occasional leak. For those with preoperative incontinence (n = 36), average pad use per day decreased significantly from 2.1 +/- 0.4 to 0.8 +/- 0.2 (P < 0.005) postoperatively. Twelve patients (15.7%) reported of de novo urgency. Six patients required reoperation including excision of vaginal mesh erosion (2), uretholysis for obstruction (1), removal of palpable vaginal suture (1), and recurrent SUI (2). Among the 21 patients who are sexually active, 19 denied any dyspareunia (90.4%). Patient satisfaction was high, as the mean value was 7.9 +/- 0.3 on a scale of 1 (least satisfied) to 10 (most satisfied). CONCLUSIONS: Transvaginal repair of complete pelvic prolapse using polypropylene mesh is a safe and efficacious option, with minimal recurrence of prolapse and SUI. While two patients had vaginal erosions, no urethral or bladder erosions occurred. Patient satisfaction was overall favorable.

Aged↗
PubMed2006

Visibility of the polypropylene tape after tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence: comparison of introital ultrasound and magnetic resonance imaging in vitro and in vivo.

OBJECTIVE: To determine whether introital sonography and magnetic resonance imaging (MRI) after TVT (tension-free vaginal tape) insertion can depict the polypropylene tape, and thus be used for patient follow-up. METHODS: The study comprised an experimental part, which investigated in-vitro visualization of the polypropylene tape in a model (phantom), and a clinical part, in which 20 women (mean age, 53.4 years) with clinically and urodynamically proven stress urinary incontinence without prolapse were investigated by introital ultrasound and MRI before and 13 months after the TVT procedure. RESULTS: In the phantom, the polypropylene tape was depicted with a low signal intensity by MRI and as a highly echogenic structure by ultrasound. In the clinical study, introital ultrasound in a mediosagittal orientation depicted the vaginal tape in all patients: it was located under either the midurethra (n = 16) or the lower urethra (n = 4), and in either the muscular coat of the urethra (n = 8) or in the urethrovaginal space (n = 12), the tape was either flat (n = 6) or curled up (n = 14), and there was no retropubic visualization of the tape. Overall, depiction by MRI was limited, and was poorer in comparison with ultrasound, especially when the tape had a sub- or paraurethral location. Retropubically, however, MRI identified the tape near the periosteum of the pubic bone (55% of cases), in the retropubic space (37.5% of cases), or near the bladder wall (7.5% of cases). CONCLUSION: Sonography is recommended for evaluation of the suburethral and paraurethral tape portions, while MRI is suitable for retropubic evaluation after the TVT procedure.

Adult↗
PubMed2001

Early imaging of integration response to polypropylene mesh in abdominal wall by environmental scanning electron microscopy: comparison of two placement techniques and correlation with tensiometric studies.

The repair of incisional hernias has taken advantage of the strength provided by prosthetic mesh grafts, but the best position for inserting the materials has not been conclusively established. Environmental scanning electron microscopy (ESEM) provides imaging of biologic samples with minimal manipulation. We used ESEM for early imaging of the integration response to polypropylene meshes placed in two anatomic positions in the abdominal wall and correlated results with tensiometric studies. Two macroporous polypropylene prostheses were implanted in a rat model--one on the abdominal aponeurotic layer and one on the peritoneal surface--without creating a wall defect. Studies were performed over implantation intervals of 7, 15, and 30 days in strips obtained from the polypropylene fiber-receptor repair tissue interface. Microscopic appearance, tensile strength, percent elongation, and stiffness were evaluated. Meshes implanted on the abdominal aponeurotic layer showed better early tissue incorporation (higher collagen deposition, capillary density, cell accumulation) and increased tensile strength, reflecting tighter anchorage to the abdominal wall. The percent elongation increased from day 7 to day 30 after implantation, mainly in the deep stratum. The ESEM images correlated well with biomechanical results, indicating the potential of this technique as a powerful, effective tool for use in wound-healing studies.

Abdominal Muscles↗