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Biologics Flashcards

0
Q

Options to using a synthetic mesh.

A
  • Treat infection or contamination first.
    • use wound VAC
    • come back later and repair
    • use synthetic and take risk
    • use biologic instead
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1
Q

List reasons why a surgeon might decide against using a synthetic mesh

A

Infection (present or risk)

Contamination (present or risk)

Synthetic mesh is permanent

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2
Q

What is a biological implant

A

A scaffold of collagen

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3
Q

What type of cases are biologic implants used in.

A

Complex cases - grade 3/4

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4
Q

What are some of the specific benefits of using biologic implants?

A

Graft goes away.

Less foreign body response.

Some believe it may reduce probability of re-operation.

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5
Q

Describe collagens role.

A

Maintain protein of connective tissue

Responsible for skin strength and structure.

Promotes healing.

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6
Q

What is the importance of collagen in a biologic?

A

Promotes healing - enables host tissue remodeling

Acts as scaffold for cell ingrowth

Minimal foreign body response

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7
Q

What are some challenges with biologics in complex cases?

A
  • Variable outcomes due to types of cases
  • Tough cases with higher failure rates
  • No proprietary techniques
  • Unanswered questions / gray areas
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8
Q

Describe the normal wound healing process.

A
  1. Injury
  2. Hemostasis
  3. Inflammation
  4. Demolition
  5. Proliferation
  6. Maturation
    REVIEW!!!
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9
Q

Describe winning ‘the race’ between wound healing and graft remodeling.

A

The race for the body to heal before the graft breaks down…..

Review!!!

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10
Q

What are factors that can affect graft remodeling?

A

Infection

Medication

Malnutrition

Comorbidities - diabetes, obesity, smoking

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11
Q

What is XenMatrix?

A

Acellular non-cross linked porcine dermis

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12
Q

Describe structure of XenMatrix.

A

Open collagen structure for early tissue remodeling and vascularization.

We have the largest sizes on the market.

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13
Q

Describe strength of XenMatrix.

A

It maintains its strength throughout the healing process.

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14
Q

Describe performance of XenMatrix.

A

Shown successful outcomes since 2006

We have the longest human clinical data

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15
Q

List features and advantages of AlloMax

A

…

REVIEW

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16
Q

Describe the tutoplast process.

A

..ll

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17
Q

What significant benefit does the tutoplast process give to our AlloMax?

A

…

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18
Q

What significant features differentiate AlloMax from any other allograft on the market?

A

….

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19
Q

What is a grade 1 hernia?

A

Low risk

Low risk of complications.

No history of wound infection.

(Synthetics)

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20
Q

What is a grade 2 hernia?

A

Co-morbid

Smoker
Obese
Diabetic
COPD

(Absorbable)

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21
Q

What is a grade 3 hernia?

A

Potentially contaminated

  • previous wound infection
  • stoma present
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22
Q

What is a grade 4 hernia?

A

Infected

  • Infected mesh
  • Septic dehiscence

(Biologics)

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23
Q

What products are generally used for all hernia grades and why?

A

Grade 1 - synthetics
Grade 2 - absorbable
Grade 3 - biologics
Grade 4 - biologics

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24
What is PHASIX indicated for?
Indicated to reinforce soft tissue where weakness exists, such as repair of hernia.
25
What are PHASIX contradictions?
Should not be used in repairs where permanent wound support from mesh is required.
26
What is the PHASIX story? Repairs, resorbs, and reliably
Repairs - open porous monofilament scaffold allows for rapid integration and strong repair Resorbs - resorted over 12-18 months leaving behind a repair site stronger than abdominal wall tissue Reliably - the hydrolysis process is not accelerated in presence of bacteria
27
What is PHASIX?
...
28
What is PHASIX technology?
P4HB - poly 4 hydroxybuterate
29
If PHASIX goes away, what is left to prevent the hernia from recurring?
The repair site actually 'stays stronger for longer.'
30
What happens to PHASIX if inadvertently exposed to bacteria?
The hydrolysis process is not accelerated in the presence of bacteria.
31
What makes PHASIX different from its competitors?
...
32
How should you position PHASIX?
....
33
What are Xen AB's basic components?
XenMatrix Coated with antibiotic Of Rifampin and Menocycline by the polymer tyrosine
34
What are the key talking points of Xen AB?
...
35
What is the technology behind Xen AB?
...
36
What are the warnings and contradictions for Xen AB?
...
37
How should you position Xen AB?
This graft is designed to protect the graft from bacteria.
38
Collamend FM | Describe cross linking and what is the affect on remodeling.
A chemical process that strengthens links between collagen fibers. Cross linking requires more time to degrade. It's more dense.
39
What are the placement options for a biologic implant?
...
40
Why is using a biologic as a bridge not ideal?
....
41
What is the goal of doing a Component Separation Technique (CST)?
...
42
Describe the Open Component Separation Technique (CST)
...
43
What are the pros of open CST?
...
44
List the cons of open CST technique.
...
45
What is important to know about using a wound VAC?
...
46
Describe the endoscopic (CST)
...
47
List pros of endoscopic component separation technique.
....
48
List cons of endoscopic component separation technique.
...l
49
Describe remodeling.
...
50
Describe the importance/benefit of the open collagen structure of XenMatrix
....
51
Strattice
Life Cell
52
XCM
Ethicon
53
Permacol
Covidien
54
SurgiSIS
Cook
55
Surgimend
TEI
56
Veritas
Baxter
57
Bio A
Gore
58
Vicryl
Ethicon
59
TIGR Matrix
Novus
60
SeriScaffold
Allergan

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