Since the 1990 s, mesh has been used in pelvic reconstruction to augment repairs for stress urinary incontinence and pelvic organ prolapse(POP). In 2008 and 2011, the United States Food and Drug Administration(FDA) is...Since the 1990 s, mesh has been used in pelvic reconstruction to augment repairs for stress urinary incontinence and pelvic organ prolapse(POP). In 2008 and 2011, the United States Food and Drug Administration(FDA) issued Public Health Notifications ultimately informing providers and the public that complications associated with the use of synthetic mesh in the transvaginal repair of POP are not rare. In this review, we(1) examine literature characterizing surgical practice-patterns subsequent to the FDA announcements;(2) describe presentation of meshassociated complications and outcomes of management;(3) discuss the most recent materials science research; and(4) seek to characterize whether or not mesh has lived up to the long-term efficacy promise of a permanent implant. Durability of mesh-augmented anatomical outcomes do not consistently translate into improved patient satisfaction and subjective outcomes. This, when coupled with the possibility of mesh-associated complications, emphasizes the need for continued innovation beyond the status quo of current synthetic grafts.展开更多
Bone loss associated with musculoskeletal trauma or metabolic diseases often require bone grafting. The supply of allograft and auto-graft bones is limited. Hence, development of synthetic bone grafting materials is a...Bone loss associated with musculoskeletal trauma or metabolic diseases often require bone grafting. The supply of allograft and auto-graft bones is limited. Hence, development of synthetic bone grafting materials is an active area of research. Chitosan, extracted from chitin present in crawfish shells, was tested as a de-livery vehicle for osteoblasts in a 2-3 mm size defect model in rats. Twenty-seven male Lewis rats, divided into three groups with sacrifice intervals of 3, 6 &9 months were used. In the experimental samples, a critical size defect was filled with chitosan bone graft paste and fixed with a plate, while in the operated control group, a critical size defect was repaired only by a plate (no paste was applied). An unoperated control group was also included. Bone growth was evaluated histologically by examining undecal-cified and decalcified stained sections. The fe-murs were also examined non-destructively by micro-computed tomography (礐T). Defects filled with chitosan bone graft paste demon-strated superior healing across all time periods compared to unfilled defects as examined by histology and micro-computed tomography. Crawfish chitosan has successfully been used as a cell delivery system for osteoblasts for use as a synthetic bone graft material.展开更多
Tendon and ligament(TL)injuries affect millions of people annually.Biopolymers play a significant role in TL tissue repair,whether the treatment relies on tissue engineering strategies or using artificial tendon graft...Tendon and ligament(TL)injuries affect millions of people annually.Biopolymers play a significant role in TL tissue repair,whether the treatment relies on tissue engineering strategies or using artificial tendon grafts.The biopolymer governs the mechanical properties,biocompatibility,degradation,and fabrication method of the TL scaffold.Many natural,synthetic and hybrid biopolymers have been studied in TL regeneration,often combined with therapeutic agents and minerals to engineer novel scaffold systems.However,most of the advanced biopolymers have not advanced to clinical use yet.Here,we aim to review recent biopolymers and discuss their features for TL tissue engineering.After introducing the properties of the native tissue,we discuss different types of natural,synthetic and hybrid biopolymers used in TL tissue engineering.Then,we review biopolymers used in commercial absorbable and non-absorbable TL grafts.Finally,we explain the challenges and future directions for the development of novel biopolymers in TL regenerative treatment.展开更多
文摘Since the 1990 s, mesh has been used in pelvic reconstruction to augment repairs for stress urinary incontinence and pelvic organ prolapse(POP). In 2008 and 2011, the United States Food and Drug Administration(FDA) issued Public Health Notifications ultimately informing providers and the public that complications associated with the use of synthetic mesh in the transvaginal repair of POP are not rare. In this review, we(1) examine literature characterizing surgical practice-patterns subsequent to the FDA announcements;(2) describe presentation of meshassociated complications and outcomes of management;(3) discuss the most recent materials science research; and(4) seek to characterize whether or not mesh has lived up to the long-term efficacy promise of a permanent implant. Durability of mesh-augmented anatomical outcomes do not consistently translate into improved patient satisfaction and subjective outcomes. This, when coupled with the possibility of mesh-associated complications, emphasizes the need for continued innovation beyond the status quo of current synthetic grafts.
文摘Bone loss associated with musculoskeletal trauma or metabolic diseases often require bone grafting. The supply of allograft and auto-graft bones is limited. Hence, development of synthetic bone grafting materials is an active area of research. Chitosan, extracted from chitin present in crawfish shells, was tested as a de-livery vehicle for osteoblasts in a 2-3 mm size defect model in rats. Twenty-seven male Lewis rats, divided into three groups with sacrifice intervals of 3, 6 &9 months were used. In the experimental samples, a critical size defect was filled with chitosan bone graft paste and fixed with a plate, while in the operated control group, a critical size defect was repaired only by a plate (no paste was applied). An unoperated control group was also included. Bone growth was evaluated histologically by examining undecal-cified and decalcified stained sections. The fe-murs were also examined non-destructively by micro-computed tomography (礐T). Defects filled with chitosan bone graft paste demon-strated superior healing across all time periods compared to unfilled defects as examined by histology and micro-computed tomography. Crawfish chitosan has successfully been used as a cell delivery system for osteoblasts for use as a synthetic bone graft material.
基金supported by the Department of Jobs,Tourism,Science and Innovation(JTSI),Government of Western Australia,through the Science Industry PhD Fellowship Program.
文摘Tendon and ligament(TL)injuries affect millions of people annually.Biopolymers play a significant role in TL tissue repair,whether the treatment relies on tissue engineering strategies or using artificial tendon grafts.The biopolymer governs the mechanical properties,biocompatibility,degradation,and fabrication method of the TL scaffold.Many natural,synthetic and hybrid biopolymers have been studied in TL regeneration,often combined with therapeutic agents and minerals to engineer novel scaffold systems.However,most of the advanced biopolymers have not advanced to clinical use yet.Here,we aim to review recent biopolymers and discuss their features for TL tissue engineering.After introducing the properties of the native tissue,we discuss different types of natural,synthetic and hybrid biopolymers used in TL tissue engineering.Then,we review biopolymers used in commercial absorbable and non-absorbable TL grafts.Finally,we explain the challenges and future directions for the development of novel biopolymers in TL regenerative treatment.
