Coating of Mesh Grafts for Prolapse and Urinary Incontinence Repair with Autologous Plasma: Exploration Stage of a Surgical Innovation

Author:

Barski Dimitri1ORCID,Gerullis Holger12ORCID,Georgas Evangelos1ORCID,Bär Andreas3,Lammers Bernhard3,Ramon Albert4,Ysebaert Dirk5,Klosterhalfen Bernd6,Boros Mihaly7,Otto Thomas12

Affiliation:

1. Department of Urology, Lukas Hospital, 41464 Neuss, Germany

2. German Centre for Assessment and Evaluation of Innovative Techniques in Medicine (DZITM), 41464 Neuss, Germany

3. Department of Surgery, Lukas Hospital, 41464 Neuss, Germany

4. ITERA (International Tissue Engineering Research Association), 2000 Antwerpen, Belgium

5. Department of Surgery, University of Antwerpen, 2000 Antwerpen, Belgium

6. German Centre for Implant-Pathology, 52351 Düren, Germany

7. Department of Experimental Surgery, University of Szeged, H-6720 Szeged, Hungary

Abstract

Purpose. Optimized biocompatibility is a major requirement for alloplastic materials currently applied for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) repair. In the preliminary studies the mesh modification by coating with autologous plasma resulted in the increased adherence scorein vitroand improved biocompatibility in an animal model. The first use of plasma coated meshes in human is presented.Materials and Methods. Between 04/2013 and 05/2014, 20 patients with the indication for SUI and POP repair were selected in a single institution. The applied meshes were modified by autologous plasma coating prior to implantation. A retrospective chart review for peri- and early postoperative complications was performed. Functional outcome and QoL were evaluated pre- and postoperatively.Results. The functional outcome and QoL improved significantly in all groups. Two reoperations (Grade IIIB) with the release of TVT-mesh in anesthesia due to the obstruction were needed. No other severe complications were registered.Conclusion. For the first time we applied a mesh modification in a human setting according toIDEALcriteria of surgical innovations. The procedure of mesh coating with autologous plasma is safe and a prospective randomized trial proving a positive effect of plasma coating on the biocompatibility and morbidity outcome with long-term registry is planned.

Publisher

Hindawi Limited

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine

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