[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-213203-en":3,"doc-seo-213203-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},213203,137454149569,"Lute","https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0",7,"Healthcare","Avoiding & Managing Mesh Complications of Surgery - The Use of Biological Materials to Avoid Complications","Surgery using prosthetic mesh and trocar-driven kits for prolapse repair has expanded rapidly despite limited safety and efficacy data. Short-term clinical series often emphasize anatomical outcomes while underplaying the morbidity risks of these devices, creating a need for critical appraisal and common-sense decision-making. Implant response depends on the biomaterial’s biochemical and structural properties: alloplastic and denatured xenografts trigger transplant-rejection immunity with predictable inflammation and late fibrosis, whereas properly prepared acellular connective tissue supports transplant acceptance, tissue induction, and remodeling driven by key biodegradability mechanisms.","Annual  \nABS TRA C TS  \nAbstracts  \nAVOIDING & MANAGING MESH COMPLICATIONS OF SURGERY  \nTHE USE OF BIOLOGICAL MATERIALS  \nTO AVOID COMPLICATIONS  \nRichard Reid  \nNewcastle University and University of New England, Australia  \nThe use of prosthetic materials and trocar driven kits in prolapse repair has risen sharply, despite a paucity of safety and efficacy data. Much of this impetus has been driven by marketing claims, not prudent practice. There is an abundance of short term clinical series which over-emphasize anatomic outcome but under-emphasize the morbidity potential of these devices. There is an urgent need for a return to critical analysis and common sense. While the concept of evidence based medicine is laudable, it equally important to recognize that surgery is a craft. The effect of implanting a given biomaterial is largely determined by its biochemical properties. Before looking for statistical guidance, gynecologists should first ensure that their mesh usage does not violate these basic biochemical rules and that their decision making remains in accord with established surgical principles.  \nImplantation of a biomaterial evokes one of two possible host responses, depending on the biochemical make up and structural organization of the implant.  \n– Alloplastic biomaterials (eg, polypropylene) and denaturedxenografts (eg, Pelvicol®) evoke a ‘transplant rejection’ immune response, orchestrated by an M1 macrophage infiltration. From this point forwards, the sequence of events is entirely predictable. Thereis invariably an initial foreign body giant cell inflammation, followed by late fibrosis at the host–implant interface. The resulting scar formation can be beneficial or morbid, depending on such local factors as tissue mobility and security of mesh fixation.  \n– In contrast, if an acellular mammalian connective tissue is prepared such that collagen structure remains architecturally normal and component matrix molecules remain viable (eg, Surgisis®), the xenograft will evoke a ‘transplant acceptance’ immune response, orchestrated by an M2 macrophage infiltration. Under these circumstances, the implanted collagen scaffold will first be repopulated by host fibroblasts and angioblasts, and then remodeled into a new layer of strong human connective tissue. Default response now becomes oneof tissue induction, rather than scar formation. Repairs with second generation biomaterials are just as permanent as with polypropylene, because constructively remodeled tissue is self-renewable under the control of collagen homeostatic mechanisms. Research has identified‘biodegradability’ as the key factor in ensuring a constructive remodeling (rather than a scarring) response.  \nPreservation of an architecturally normal collagen structure and still viable matrix molecules creates a “biodegradable scaffold with an ingrained information highway”.  \nThere is a striking discordance in how information on extracellular matrix grafting has been received amongst engineers and scientists, as compared to surgeons. The development of tissue inductive therapeutic scaffolds has created a paradigm shift in Biomaterials Science; it has also attracted substantial investment from Industry. In contrast, 20 years of ingenious preclinical evaluation has passed virtually unnoticed in clinical circles. Prolapse surgeons have persisted in the use of unduly morbid polypropylene devices or cross-linked xenografts. articles from the do not achieve circulation amongst clinicians. There is an urgent need for surgeons to assimilate the knowledge attained through the preclinical experiments reported in the scientific literature.  \n1. Reid RI. A comparative analysis of biomaterials currently used in pelvic reconstructive surgery. In: Von Theobald P, Zimmerman CW, Davila W, eds. Vaginal Prolapse Surgery: New Techniques. Springer-Verlag, Guildford, U.K. 2009 (In Press) .  \nMESH? PESSARIES REVISITED    \nDavid Molloy  \nBrisbane, Queensland-Australia  \nThe use of various","cbCailedV5PU5NNY","https://ap.wps.com/l/cbCailedV5PU5NNY","pdf",631446,1,14,"English","en",105,"# Avoiding & Managing Mesh Complications of Surgery\n## The use of biological materials to avoid complications\n## Host immune responses to biomaterial properties","[{\"question\":\"Why has mesh use in prolapse repair increased despite limited evidence?\",\"answer\":\"Its rise has been driven largely by marketing claims rather than prudent practice, even though safety and efficacy data remain scarce.\"},{\"question\":\"How do alloplastic meshes and denatured xenografts typically affect the host response?\",\"answer\":\"They evoke a transplant-rejection immune response involving M1 macrophage infiltration, leading to giant-cell inflammation and late fibrosis at the host–implant interface.\"},{\"question\":\"What immune response occurs with acellular mammalian connective tissue scaffolds like Surgisis?\",\"answer\":\"They evoke transplant acceptance with M2 macrophage infiltration, followed by repopulation with host cells and remodeling into strong human connective tissue.\"}]","Avoiding & Managing Mesh Complications of Surgery - The Use of Biological Materials to Avoid Complications | PDF",1788754847,35,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":28},"avoiding-managing-mesh-complications-of-surgery-the-use-of-biological-materials-to-avoid-complications","",{"@graph":36,"@context":86},[37,54,69],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/avoiding-managing-mesh-complications-of-surgery-the-use-of-biological-materials-to-avoid-complications/213203/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":23,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-09-11","2026-09-07",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"Why has mesh use in prolapse repair increased despite limited evidence?","Question",{"text":76,"@type":77},"Its rise has been driven largely by marketing claims rather than prudent practice, even though safety and efficacy data remain scarce.","Answer",{"name":79,"@type":74,"acceptedAnswer":80},"How do alloplastic meshes and denatured xenografts typically affect the host response?",{"text":81,"@type":77},"They evoke a transplant-rejection immune response involving M1 macrophage infiltration, leading to giant-cell inflammation and late fibrosis at the host–implant interface.",{"name":83,"@type":74,"acceptedAnswer":84},"What immune response occurs with acellular mammalian connective tissue scaffolds like Surgisis?",{"text":85,"@type":77},"They evoke transplant acceptance with M2 macrophage infiltration, followed by repopulation with host cells and remodeling into strong human connective tissue.","https://schema.org",{"og:url":52,"og:type":88,"og:title":13,"og:site_name":59,"og:description":14},"article",{"robots":90,"canonical":52},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":93},[94,98,102,106,111,116,119,124,129,132,136],{"id":20,"doc_module":4,"doc_module_name":46,"category_name":95,"show_sort_weight":96,"slug":97},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":99,"show_sort_weight":100,"slug":101},"Literature",80,"literature",{"id":53,"doc_module":4,"doc_module_name":46,"category_name":103,"show_sort_weight":104,"slug":105},"Exam",70,"exam",{"id":107,"doc_module":4,"doc_module_name":46,"category_name":108,"show_sort_weight":109,"slug":110},5,"Comic",60,"comic",{"id":112,"doc_module":4,"doc_module_name":46,"category_name":113,"show_sort_weight":114,"slug":115},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":117,"slug":118},40,"healthcare",{"id":120,"doc_module":4,"doc_module_name":46,"category_name":121,"show_sort_weight":122,"slug":123},8,"Research & Report",30,"research-report",{"id":125,"doc_module":4,"doc_module_name":46,"category_name":126,"show_sort_weight":127,"slug":128},9,"Religion & Spirituality",20,"religion-spirituality",{"id":127,"doc_module":4,"doc_module_name":46,"category_name":130,"show_sort_weight":127,"slug":131},"World Cup","world-cup",{"id":133,"doc_module":4,"doc_module_name":46,"category_name":134,"show_sort_weight":133,"slug":135},10,"Lifestyle","lifestyle",{"id":137,"doc_module":4,"doc_module_name":46,"category_name":138,"show_sort_weight":107,"slug":139},19,"General","general"]