The Use of a Corrective Procedure with Vicryl Mesh for Oncoplastic Surgery of the Breast / 한국유방암학회지

PURPOSE: In addition to the oncological results, cosmetic results are very important to cancer patients. Currently, the use of oncoplastic surgery is an emerging approach. In this study, we examined the clinical outcomes of the use of a corrective procedure with an absorbable implant, a Vicryl mesh(R), as compared with the use of conventional breast conserving surgery (BCS). METHODS: Fifty six patients who completed questionnaire were enrolled in the study. For 33 cases, BCS was performed concurrently with the use of a Vicryl mesh and for the other 23 cases, conventional BCS alone was performed. Contraindications of the use of corrective procedure were a patient age over 60 year, diabetes, neoadjuvant chemotherapy and a previous excisional biopsy performed on the same breast. Patients rated their cosmetic outcomes by use of a four point scale. RESULTS: For one of 34 cases, the Vicryl mesh was removed due to infection and this patient was excluded from the study. Twenty seven of the remaining 33 patients (82%) who underwent the corrective procedure with Vicryl mesh were satisfied with their outcome. For patients that received conventional BCS only ten of 23 patients (43%) were satisfied with their outcome (p=0.05). Patient age, body mass index (BMI) and tumor location did not affect the cosmetic outcomes of the corrective procedure. When the resection area of the breast was 40-70 cm2, 88% of the patients were satisfied with their outcome. CONCLUSION: This study suggested that the use of Vicryl mesh correction was superior to the use of conventional BCS alone for cosmesis. This method appears to provide a satisfactory outcome for oncoplastic surgery of the breast.

Comparison between the Exposure Rates of Tutoplast(R) and Vicryl Mesh Used as Wrapping Materials for Hydroxyapatite Orbital Implant

PURPOSE: To compare the exposure rates of two wrapping materials for hydroxyapatite (HA) ocular implants (Tutoplast(R) vs. vicryl mesh). METHODS: We reviewed the medical records of 137 eyes of 137 patients who had received intraorbital HA implantation from March 1997 to March 2001. RESULTS: We used Tutoplast(R) in 72 patients and vicryl mesh in 65 patients. The mean follow-up period was 22.1 months. Implant exposure developed in four cases of eyes using vicryl mesh. No case of exposure occurred in eyes using Tutoplast(R). The mean period from operation and implant exposure was 3.5 weeks (1.5~5 weeks). CONCLUSIONS: When vicryl mesh was used as the wrapping material for HA intraorbital implant it is advisable to pay more attention to the possible postoperative implant exposure than when Tutoplast(R) was used.

The Clinical Experience of Hydroxyapatite Implantation using Autologous Sclera and Vicryl Mesh

The hydroxyapatite implant, recetnly widely used new intraorbital implant, in light, highly biocompatible, characterized by easy fibrovascular proliferation. Thus, when inserted after evisceration, it has some beneficial effect cosmetically: it can cause less protrusion of implant or alteration of position and can have good artificial eye motion by linking to the implant. However, in case of hydroxyapatite implantation after evisceration with the cornea preserved, there is a risk of cornea melting by contact with the implant, and in case with the cornea preserved of the eyeball size being too small, hydroxyapatite implant is impossible after evisceration. Hydroxyapatite implantation is done after enucleation using donor sclera, which is not readily available in Korea. Thus we inserted hydroxyapatite implant covered with circular from of Vicryl mesh on endothelium after evisceration in 11 eyes, and inserted hydroxyapatite implant using autologous sclera with Vicryl mesh after enucleation in 3 eyes, in which 18 mm-sized implant could not be implanted after evisceration from August 195 to July 1996. Follow-up examination was done during 6 to 20 (mean 12.9) months postoperatively. Motion of extraocular muscle was very good. During follow-up examination, adverse effects such as conjunctival wound dehiscence and exposure or protrusion of hydroxyapatite implant through the conjunctiva didn`t occur. It should be considered an excellent operative method, because the hydroxyapatite implantation using autologous sclera with Vicryl mesh decreases the risk of exposure or protrusion of the implant and can be performed without the use of donor sclera.

The Effect of Physical Barriers on Delayed Adjustable Strabismus Surgery

Delayed reattachment of the muscle to the sclera may be desirable to correct the angle of deviation developed after the surgery of strabismus. In order to know the possible time for the delayed adjustment, the authors tried Viscoat(R). Interceed(TC7) and polyglactin 910 mesh(Vicryl mesh(R)) as physical barriers for preventing the formation of postoperative adhesions. These materials were placed around between the detached end of the muscle and the sclera in 29 rabbits and adjustment was performed thereafter. Viscoat(R) was effective in delaying the adjustment up to 6 days after surgery. Interceed(TC7) and polyglactin 910 mesh were effective in delaying the adjustment up to 1 week after surgery.

Surgical Repair of the Kidney after Blunt Renal Injury Using a Vicryl Mesh an Experimental Study / 대한비뇨기과학회지

Eighteen experimentally induced blunt and sharp renal injury in rabbits were treated either with an alloplastic renal capsule made of Vicryl mesh or with through and through chromic catgut sutures or with no suture as controls. A simple apparatus was used to cause uniform renal injury and the device was modification of an AO Kuntscher nail extractor. The Vicryl mesh capsule was made by ourselves with #2 and #4 Vicryl. The postoperative healing course were followed up until 6 weeks and isotope renogram showed good renal function in 15 cases. However, when compared to the controls, the kidney which had been repaired with Vicryl mesh contained considerably less scar and showed neither perirenal fibrosis or atrophy of the parenchyma in the vicinity of the capsule. Our preliminary results seem to confirm that simple and rapid surgical treatment of intermediate degree renal injuries is possible using the alloplastic Vicryl mesh capsule. The method may be also suitable for reconstruction of the parenchyma following nephrotomies, such as for removal of staghorn calculi.