Association of PDO threads and technologies-Facial treatment protocols.

BACKGROUND: Aging is part of the immutable characteristics of the human being, and the search for treatments to alleviate the undesirable effects of aging is frequent in the dermatological office. AIMS: This work proposes the technique of association of PDO threads with technologies and the description of the facial treatment protocols. METHODS: For contextualization, two case studies of two patients subjected to the procedure are analyzed. CONCLUSIONS: In recent years, there have been marked changes in facial rejuvenation techniques using PDO threads and these have shown satisfactory results for collagen biostimulation. Having technologies in dermatological clinics is a frequent reality, and sometimes, some doctors are in doubt about when to use them associated with PDO wires and in which sequence it should be done, ensuring patient safety and maintaining the integrity of the wires. This article aims to bring clarity about how to use technology and when is the right time. It is also intended to clarify that the PDO wire can be used in conjunction with the microfocused ultrasound technology, since the melting point of the PDO polymer is between 110° and 115°C.

Orbital floor fractures: epidemiology and outcomes of 1594 reconstructions.

OBJECTIVE: The aim of this study was to retrospectively review the midface and orbital floor fractures treated at our institution with regard to epidemiological aspects, surgical treatment options and postoperative complications and discuss this data with the current literature. STUDY DESIGN: One thousand five hundred and ninety-four patients with midface and orbital fractures treated at the Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery of the Goethe University Hospital in Frankfurt (Germany) between 2007 and 2017 were retrospectively reviewed. The patients were evaluated by age, gender, etiology, fracture pattern, defect size, surgical treatment and complications. RESULTS: The average patient age was 46.2 (± 20.8). Most fractures (37.5%) occurred in the age between 16 and 35. Seventy-two percent of patients were male while 28% were female. The most common cause of injury was physical assault (32.0%) followed by falls (30.8%) and traffic accidents (17.0%). The average orbital wall defect size was 297.9 mm2 (± 190.8 mm2). For orbital floor reconstruction polydioxanone sheets (0.15 mm 38.3%, 0.25 mm 36.2%, 0.5 mm 2.8%) were mainly used, followed by titanium meshes (11.5%). Reconstructions with the 0.15 mm polydioxanone sheets showed the least complications (p < 0.01, r = 0.15). Eighteen percent of patients who showed persistent symptoms and post-operative complications: 12.9% suffered from persistent hypoesthesia, 4.4% suffered from post-operative diplopia and 3.9% showed intra-orbital hematoma. CONCLUSION: Results of the clinical outcome in our patients show that 0.15 mm resorbable polydioxanone sheets leads to significantly less post-operative complications for orbital floor defects even for defects beyond the recommended 200 mm2.

Application of Polydioxanone Sutures in the Nuss Procedure.

BACKGROUND/PURPOSE: The Nuss procedure is the most common surgical repair for pectus excavatum (PE). Surgical steel wires are used in some modifications of the Nuss procedure to attach one or both ends of a support bar to the ribs. During follow-up, wire breakage was found in some cases. Patients with wire breakage may undergo prolonged bar removal surgery and may be exposed to excessive radiation.In this study, we had a series of patients who received polydioxanone suture (PDS) fixations instead of steel wires. This retrospective study was conducted to explore the differences between these two fixation materials in the incidence of related complications and efficacies. Furthermore, we attempted to observe whether the two materials lead to similar surgical efficacy in the Nuss procedure, whether they have divergent effects on the bar removal surgery, and whether PDS can reduce the risks due to steel wire breakage as expected. METHODS: We retrospectively studied PDS and surgical steel wires as fixation materials for the Nuss procedure in children with congenital PE and reviewed the outcomes and complications. A total of 75 children who had undergone Nuss procedure repairs and bar removals from January 2013 to December 2019 were recruited to participate in this study. They were divided into three groups: the PDS group, the unbroken wire (UBW) group, and the broken wire (BW) group, according to the fixation materials and whether the wires had broken or not. Moreover, we selected the duration of operation (DO), intraoperative blood loss (BL), bar displacement (BD), postoperative pain score (PPS), and incision infection as the risk indicators and the postrepair Haller index (HI) as the effectiveness indicator. These indicators were statistically compared to determine whether there were differences among the three groups. RESULTS: One BD occurred in the PDS and BW groups while none took place in the UBW group. No incision infection was found in any of the groups. The PDS group had the shortest DO, while the DO in the UBW group was shorter than that in the BW group (p < 0.05). BL in the PDS group was less than that in the other two groups (p < 0.05). Additionally, no difference was observed in BL between the BW and UBW groups (p > 0.05). The PPS of the PDS group was less than that of the BW group (p < 0.05), whereas no differences were found between the other two groups. No statistical difference emerged in HI among the groups (p > 0.05). CONCLUSION: PDS fixation results in a similar repair outcome and shows certain advantages in the DO, BL, and PPS; also, PDSs are safe and effective in the Nuss procedure. LEVEL OF EVIDENCE: Level III.

Histological evaluation of cellular response to a multifilament electrospun suture for tendon repair.

BACKGROUND: Rotator cuff tendon repair in humans is a commonly performed procedure aimed at restoring the tendon-bone interface. Despite significant innovation of surgical techniques and suture anchor implants, only 60% of repairs heal successfully. One strategy to enhance repair is the use of bioactive sutures that provide the native tendon with biophysical cues for healing. We investigated the tissue response to a multifilament electrospun polydioxanone (PDO) suture in a sheep tendon injury model characterised by a natural history of failure of healing. METHODOLOGY AND RESULTS: Eight skeletally mature English Mule sheep underwent repair with electrospun sutures. Monofilament sutures were used as a control. Three months after surgery, all tendon repairs healed, without systemic features of inflammation, signs of tumour or infection at necropsy. A mild local inflammatory reaction was seen. On histology the electrospun sutures were densely infiltrated with predominantly tendon fibroblast-like cells. In comparison, no cellular infiltration was observed in the control suture. Neovascularisation was observed within the electrospun suture, whilst none was seen in the control. Foreign body giant cells were rarely seen with either sutures. CONCLUSION: This study demonstrates that a tissue response can be induced in tendon with a multifilament electrospun suture with no safety concerns.

Biodegradable Stents for the Relief of Vascular Bronchial Compression in Children With Left Atrial Enlargement.

BACKGROUND: We report our experience of the biodegradable polydioxanone stent in cases of bronchial compression by a dilated left atrium in children with heart disease. METHODS: Eight custom-made biodegradable stents were inserted into the left main bronchus in 5 patients diagnosed with critical airway compression. Four of the 5 patients were ventilator-dependent with significant cardiac morbidity. RESULTS: Stents were inserted without complication under fluoroscopic guidance. All experienced improvement in symptoms over time. In 3 patients, repeat bronchial stenting was performed where stent degradation was associated with recurrence of vascular airway compression and symptoms. No stents migrated nor was there evidence of bronchial or vascular erosion. There was 1 death, unrelated to the stent, and all remaining survivors were well at a 2-year follow-up. CONCLUSION: The use of the polydioxanone biodegradable stent appeared safe in this cohort of critically ill patients with vascular bronchial compression. There use may aid weaning from mechanical ventilation and support eventual cardiac recovery.

Microscopic and clinical evidence of the degradation of polydioxanone lifting threads in the presence of hyaluronic acid: a case report. / Evidencia clínica y microscópica de la degradación de hilos de dermosustentación de polidioxanona en presencia de ácido hialurónico: reporte de caso.

We present the case of a female patient with complications from superficial implantation of polydioxanone spiculated threads in the facial middle third. The manifestations were edema, ecchymosis, superficial palpation of the thread and skin plication. For the treatment we propose a novel protocol of clinical degradation of polydioxanone threads, using hyaluronic acid injecting it into the implantation area of the polydioxanone threads. Non-cross linked hyaluronic acid was infiltrated along the path of the thread. The follow-up at seven, 21 and 45 days showed decreased edema, folds and skin irregularities due to wire traction and attenuation of secondary rhytides. A sample of the thread in hyaluronic acid was observed in a laminar flow campaign evidencing degradation at 72 hours. Administering hyaluronic acid was effective in inducing clinical biodegradation of the thread suggesting that non-crosslinked hyaluronic acid is a powerful catalyst for the hydrolytic degradation of polydioxanone.

Se expone el caso de una paciente remitida por complicaciones posteriores a la implantación superficial en el tercio medio facial de hilos de polidioxanona espiculados. Presentaba edema, equimosis, palpación superficial del hilo y plicación dérmica. Para el tratamiento planteamos un novedoso protocolo de degradación clínica de hilos de polidioxanona, empleando ácido hialurónico inyectándolo en el área de su implantación. Se infiltró ácido hialurónico no reticulado en el trayecto a lo largo del recorrido del hilo. El seguimiento a los siete, 21 y 45 días evidenció disminución del edema, de los pliegues e irregularidades dérmicas por la tracción del hilo y atenuación de rítides secundarias. Una muestra del hilo en ácido hialurónico fue observado en campana de flujo laminar evidenciándose degradación a las 72 horas. Administrar ácido hialurónico fue efectivo para inducir la biodegradación clínica del hilo. La hipótesis derivada sugiere que el ácido hialurónico no reticulado es un poderoso catalizador de la degradación hidrolítica de la polidioxanona.

Biostimulatory effects of polydioxanone, poly-d, l lactic acid, and polycaprolactone fillers in mouse model.

BACKGROUND: Numerous fillers are increasingly used for augmentation of volume loss and relaxation of facial wrinkles. Collagen stimulators are the latest next-generation dermal fillers that can induce neocollagenesis. To investigate biophysical characteristics, safety, and efficacy of newly developed polydioxanone (PDO) filler in comparison with poly-l lactic acid (PLLA) and polycaprolactone (PCL) fillers. METHODS: In vitro assay, morphology of particles, and rheological property of fillers were measured. A total of 24 female hairless mice (SKH1-Hrhr ) were randomly divided into three groups and injected with PDO, PLLA, or PCL fillers. Durability of fillers was assessed at 0, 3 days, and 1, 4, 8, 12 weeks after injection using folliscope and PRIMOS. To determine biocompatibility and neocollagenesis, histologic evaluation was performed at 1, 4, 8, and 12 weeks after injection. Efficacy was also evaluated based on skin surface roughness changes using PRIMOS in a hairless mouse photoaging model. RESULTS: In the particle morphology test, PDO microspheres had an irregular surface and were spherical and uniformly sized. PDO filler demonstrated similar neocollagenesis and inflammatory response to other collagen stimulators. PDO filler showed better biodegradability than PLLA and PCL fillers. In the hairless mouse photoaging model, there was a statistically significant decrease in skin surface roughness after PDO filler injection. CONCLUSIONS: Our data suggest that newly developed collagen stimulating PDO filler might be a safe and effective option for correction of volume loss and rejuvenation of photoaging skin.

Wedge-shaped polydioxanone threads in a folded configuration ("Solid fillers"): A treatment option for deep static wrinkles on the upper face.

BACKGROUND: Facial wrinkles are key signs of aging which affect one's quality of life and psychological well-being. Absorbable wedge-shaped polydioxanone (PDO) sutures are popular in the esthetic clinics of Korea and may be a treatment option for static wrinkles on the upper face. OBJECTIVE: To describe a novel technique applicable to deep static wrinkles on the upper face and to assess its safety and efficacy. PATIENTS AND METHODS: A retrospective chart review was performed on the static wrinkle cases which were treated with folded, wedge-shaped PDO threads. A total of 33 Korean patients with glabellar and forehead wrinkles were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the patients' satisfaction scores. Complications were also recorded. RESULTS: Our patients displayed moderate (15.2%), severe (39.4%), and very severe (45.4%) static wrinkles at baseline. The majority of patients (81.8%) considered the results satisfactory. Consensus ratings by two independent dermatologists showed that the objective outcomes at 2-month follow-up were very much improved (30.3%), much improved (30.3%), and improved (24.2%). The incidence of complications was low, and the complications were minor. CONCLUSION: Wedge-shaped PDO sutures in a folded configuration ("solid fillers") are a promising treatment option for deep static wrinkles on the upper face. They may be applied as an adjunct, or as an alternative to conventional therapies such as botulinum toxin and soft tissue filler injection.

Comparative effects of various absorbable threads in a rat model.

BACKGROUND: Conventional procedures including botulinum toxin and filler injections have their limitations in improving deep wrinkles and decreasing tissue laxity, and possess the propensity for vascular accidents. Absorbable thread is a recently commercialized field, but there is little evidence on comparative superiority. OBJECTIVES: We observed the effects of polydiaxanone (PDO) threads with different number of strands in relation to collagen production and histopathology in a rat model. MATERIALS AND METHODS: Dorsal skin of rat was divided into five different compartments and four different PDO threads and monofilament poly-lactic acid (PLA) thread were inserted. Tissue samples were obtained at week 1, 2, and 12 after the procedure for histopathologic review and real-time PCR for quantification of collagen. RESULTS: Multiple PDO filaments produced more collagen at 2 weeks. Single-stranded PLA thread insertion resulted in more Col1α1 levels than the double PDO thread and also showed the most Col1α3 production at week 2. The amount of collagen showed a sharp decline at week 12. Histologic evaluation showed retained threads surrounded by fibrous capsule-like structure at week 12. CONCLUSION: We were able to observe more collagen production in multiple stranded PDO threads compared to a single strand and that increasing number of threads leads to more collagen synthesis.

Evidencia clínica y microscópica de la degradación de hilos de dermosustentación de polidioxanona en presencia de ácido hialurónico: reporte de caso / Microscopic and clinical evidence of the degradation of polydioxanone lifting threads in the presence of hyaluronic acid: a case report

Se expone el caso de una paciente remitida por complicaciones posteriores a la implantación superficial en el tercio medio facial de hilos de polidioxanona espiculados. Presentaba edema, equimosis, palpación superficial del hilo y plicación dérmica. Para el tratamiento planteamos un novedoso protocolo de degradación clínica de hilos de polidioxanona, empleando ácido hialurónico inyectándolo en el área de su implantación. Se infiltró ácido hialurónico no reticulado en el trayecto a lo largo del recorrido del hilo. El seguimiento a los siete, 21 y 45 días evidenció disminución del edema, de los pliegues e irregularidades dérmicas por la tracción del hilo y atenuación de rítides secundarias. Una muestra del hilo en ácido hialurónico fue observado en campana de flujo laminar evidenciándose degradación a las 72 horas. Administrar ácido hialurónico fue efectivo para inducir la biodegradación clínica del hilo. La hipótesis derivada sugiere que el ácido hialurónico no reticulado es un poderoso catalizador de la degradación hidrolítica de la polidioxanona.

We present the case of a female patient with complications from superficial implantation of polydioxanone spiculated threads in the facial middle third. The manifestations were edema, ecchymosis, superficial palpation of the thread and skin plication. For the treatment we propose a novel protocol of clinical degradation of polydioxanone threads, using hyaluronic acid injecting it into the implantation area of the polydioxanone threads. Non-cross linked hyaluronic acid was infiltrated along the path of the thread. The follow-up at seven, 21 and 45 days showed decreased edema, folds and skin irregularities due to wire traction and attenuation of secondary rhytides. A sample of the thread in hyaluronic acid was observed in a laminar flow campaign evidencing degradation at 72 hours. Administering hyaluronic acid was effective in inducing clinical biodegradation of the thread suggesting that non-crosslinked hyaluronic acid is a powerful catalyst for the hydrolytic degradation of polydioxanone.

Tissue repair in neonatal and paediatric surgery: Analysis of infection in surgical implantation of synthetic resorbable biomaterials.

BACKGROUND: There has been increased interest in the use of biomaterials that resorb completely leaving only the patient's native tissue. Synthetic materials are advantageous for tissue repair because they are highly customisable. The infection rate of using resorbable natural materials in paediatric surgery has recently been outlined, but there has not yet been a review of the use of synthetic resorbable materials in paediatric surgery. OBJECTIVES: This systematic review analyses the risk of infection after implantation of fully resorbable synthetic biomaterials in paediatric cases. METHODS: The literature was searched from January 1970 to January 2018 (inclusive), specifically searching for paediatric cases (0-18 years old), use of synthetic resorbable materials and infection. RESULTS: The infection rate in 3573 cases of synthetic resorbable material implantation was 1.1% (41 cases). A Chi-squared test for independence found infection rate to vary among materials. Of the many biomaterials identified in this review, the highest infection rates were seen in Suprathel's use in burns injuries (12.1%). CONCLUSIONS: This review found a low infection rate in synthetic resorbable materials used in paediatric surgery, with particularly strong evidence for low infection risk in LactoSorb® use.

Complications of Polydioxanone Foil Use in Nasal Surgery: A Case Series.

Polydioxanone (PDS) foil is widely recognized as a septal cartilage replacement during rhinoplasties and is thought to be completely resorbable and biodegradable. Since its United States Food and Drug Administration approval in 2010, PDS foil has drawn significant enthusiasm and many surgeons consider it an ideal implantable biomaterial as reflected in numerous studies highlighting its benefits. However, scant literature exists highlighting relevant complications of PDS plates that may potentially lead to cavalier overuse. This descriptive case series assesses the outcomes of PDS foil usage in three patients seen for septoplasty at two independent institutions over the past 5 years. Our results demonstrate that PDS plate usage can lead to septal cartilage loss and resultant saddle nose deformity associated with prolonged postoperative edema and inflammation. To our knowledge, this is the largest case series of this reported phenomenon.

Outcome of facial rejuvenation with polydioxanone thread for Asians.

BACKGROUND: Techniques in rejuvenating the aging face have evolved, involving various types of threads. Facial rejuvenation with absorbable polydioxanone is popular in aesthetic clinics in Korea. AIM: The purpose of this study was to describe our polydioxanone thread method and to evaluate the outcomes of facial rejuvenation. PATIENTS/METHODS: A retrospective chart review was performed over a 12-month period. Thirty-five Asian patients were included. All participants underwent thread-lifting using polydioxanone. On each side, five 360° spiral cog threads were used in the procedure. The results were evaluated using photography and patient satisfaction. RESULTS: Thirty-three patients (94.3%) were satisfied with the outcomes. Objective outcomes using photography were categorized as very much improved (68.6%), much improved (25.7%), and improved (5.7%). Subjective outcomes using patients' satisfaction were categorized as excellent, very good, good, fair, and poor. The incidence of complications was low, and the complications resolved spontaneously without any surgical interventions. Asymmetry, however, was noted. CONCLUSIONS: Using our technique, we could achieve the desired facial rejuvenation. Our method demonstrated an excellent success rate in patients with moderate degree laxity. We believe that facial rejuvenation with polydioxanone thread for Asians is a safe and effective treatment method.

Investigation on the Cutaneous Change Induced by Face-Lifting Monodirectional Barbed Polydioxanone Thread.

BACKGROUND: Owing to its potentially greater mechanical force on the implanted tissue, barbed thread is frequently used in face-lifting procedures. However, the long-term durability thereof remains controversial. Moreover, reports on underlying histologic and molecular changes resulting from face-lifting procedures are scarce. OBJECTIVE: To evaluate histologic and molecular changes induced by absorbable, barbed face-lifting thread in an animal model. MATERIALS AND METHODS: Fragments of monofilament, monodirectionally barbed polydioxanone thread were implanted in dorsal skin from 12 guinea pigs. Tissue samples were harvested at 1, 3, and 7 months thereafter. Histopathologic analysis and quantification of Type 1 collagen and transforming growth factor beta 1 (TGF-ß1) levels were performed. RESULTS: Implantation of a single fragment induced fibrous capsule around the thread. Tissue reactions were strongest at 1 month after implantation, showing marked infiltration of inflammatory cells and fibroblasts, which gradually decreased. On molecular analysis, Type 1 collagen and TGF-ß1 levels were significantly increased, compared to normal skin, throughout the 7-month study period. CONCLUSION: Our results suggest that implantation of barbed thread induces strong anchorage to skin tissue. Quantitative analysis of collagen and its downstream signaling molecule TGF-ß supports the long-term durability of the thread. Therefore, the authors expect potential beneficial effect for rejuvenation on its clinical application.

Biodegradable airway stents in infants - Potential life-threatening pitfalls.

OBJECTIVE: The solution of severe tracheobronchial obstructions in early childhood means a great challenge. Biodegradable stents were intended to be a minimally invasive temporary solution which may decrease the number of interventions and limit the possible complications of stenting procedures. However, our first experiences have brought out a new, - especially in childhood - potentially life-threatening complication of this concept. METHODS: Five SX-ELLA biodegradable polydioxanone stents was applied in three patients because of severe tracheobronchial obstruction: congenital tracheomalacia (7 day-old), acquired tracheomalacia (10 month-old), and congenital trachea-bronchomalacia (10 month-old). RESULTS: The breathing of all children improved right after the procedure. We observed degradation of the stent from the 5th postoperative week which resulted in large intraluminar fragments causing significant airway obstruction: one patient died of severe pneumonia, the other baby required urgent bronchoscopy to remove the obstructing 'foreign body' from the trachea. In the third case repeated stent placements successfully maintained the tracheal lumen. CONCLUSIONS: Polydioxanone stents may offer an alternative to metallic or silastic stents for collapse or external compression of the trachea in children; however, large decaying fragments mean a potential risk especially in the small size pediatric airway. The fragmentation of the stent, which generally starts in the 4-6 postoperative weeks, may create large sharp pieces. These may be anchored to the mucosa and covered by crust leading to obstruction. As repeated interventions are required, we do not consider the application of biodegradable stents unambiguously advantageous.

Early skin reaction of polydioxanone suture material following septorhinoplasty.

BACKGROUND: Septorhinoplasty is a frequent surgical procedure used for both cosmetic and functional purposes. The technique varies from surgeon to surgeon and according to which suture material is used. While some surgeons prefer non-absorbable sutures, others prefer sutures with delayed absorption. These materials sometimes protrude from the skin and they may cause skin reactions. While these reactions are common in the late period, a skin reaction in the early period because of polydioxanone suture is extremely rare and to the best of our knowledge, this is the first such reported case in the literature. CASE REPORT: A 25-year-old male patient underwent endonasal septorhinoplasty procedure with endo-tracheal general anesthesia. We hereby present the skin reaction because of frequently used polydioxanone suture on the 24th postoperative day and the management of this patient. We cut the suture at skin level and prescribed antibiotherapy, and we scheduled a follow-up for 10 days afterwards. The patient had no complaint and the control examination result was normal. CONCLUSIONS: When performing septorhinoplasty operations, very rare complications of the procedure shouldn't be ignored and an informed consent must be obtained after explaining possible complications before the operation. This approach is important for increasing the patient compliance and proper follow-up for the patient. This way, especially post-operative early complications as our case will be able to be solved with close follow-up and intervention, before causing permanent damage. The relationship between patient who underwent rhinoplasty and the physician also has an important role on these follow-up visits.

Quantitative assessment and determinants of suture-holding capacity of human pancreas.

BACKGROUND: Hard pancreas is welcome by surgeons performing resective pancreatic surgery, because it is believed to offer better suture holding capacity (SHC), thus decreasing the risk for a postoperative leak. However, neither the actual SHC of pancreatic tissue in humans nor its determinants have been studied. METHODS: We directly measured SHC for polydioxanone 5-0 suture and tissue hardness at the pancreatic isthmus in 53 human pancreata using a dynamometer and a durometer. A histologic score based on fibrosis grade, fat content, pancreatic duct size, and signs of chronic pancreatitis was calculated for every sample. We tested the hypothesis that SHC of the pancreas was proportional to tissue hardness, and evaluated the role of different possible histomorphologic determinants of SHC. RESULTS: Suture-holding capacity correlated perfectly with tissue hardness (r = 0.98; P < 0.001; 95% confidence interval, 0.96-0.99). The histologic score showed a stronger correlation with both parameters than any single histologic parameter. The SHC of transductal sutures was significantly higher than that of pure transparenchymal sutures. The SHC and hardness were significantly lower in patients who developed a clinically relevant pancreatic fistula postoperatively. CONCLUSIONS: A mixture of histomorphologic features of human pancreas determines its tissue hardness and SHC. Involvement of the main pancreatic duct in the suture line appears to increase the mechanical strength of the pancreatic anastomosis.

Primary results of chest wall reconstruction with polydioxanone mesh on animals.

BACKGROUND: With the development of surgical techniques and biomedical material, increasing synthetic materials are applied to the chest wall reconstruction, such as autologous rib, muscle flap, bovine pericardium and sheet metal. AIM: To detect the safety and efficiency of synthetic material Polydioxanone (PDO) in chest wall reconstruction. MATERIALS AND METHODS: Healthy adult mongrel dogs operated with PDO, and then some clinical data were collected. RESULTS: Here we showed that PDO mesh could close down the function of chest wall defect, and PDO mesh could be degraded gradually and forms a fibrous layer with the surrounding tissues. Our data further demonstrated PDO mesh leads to slight lung adhesion with a small shrinkage. CONCLUSIONS: These findings thus provide the first evidence that the feasibility of PDO mesh in chest wall reconstruction in dogs.