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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
Q

What is PHASIX indicated for?

A

Indicated to reinforce soft tissue where weakness exists, such as repair of hernia.

25
Q

What are PHASIX contradictions?

A

Should not be used in repairs where permanent wound support from mesh is required.

26
Q

What is the PHASIX story? Repairs, resorbs, and reliably

A

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
Q

What is PHASIX?

28
Q

What is PHASIX technology?

A

P4HB - poly 4 hydroxybuterate

29
Q

If PHASIX goes away, what is left to prevent the hernia from recurring?

A

The repair site actually ‘stays stronger for longer.’

30
Q

What happens to PHASIX if inadvertently exposed to bacteria?

A

The hydrolysis process is not accelerated in the presence of bacteria.

31
Q

What makes PHASIX different from its competitors?

32
Q

How should you position PHASIX?

33
Q

What are Xen AB’s basic components?

A

XenMatrix

Coated with antibiotic

Of Rifampin and Menocycline by the polymer tyrosine

34
Q

What are the key talking points of Xen AB?

35
Q

What is the technology behind Xen AB?

36
Q

What are the warnings and contradictions for Xen AB?

37
Q

How should you position Xen AB?

A

This graft is designed to protect the graft from bacteria.

38
Q

Collamend FM

Describe cross linking and what is the affect on remodeling.

A

A chemical process that strengthens links between collagen fibers. Cross linking requires more time to degrade. It’s more dense.

39
Q

What are the placement options for a biologic implant?

40
Q

Why is using a biologic as a bridge not ideal?

41
Q

What is the goal of doing a Component Separation Technique (CST)?

42
Q

Describe the Open Component Separation Technique (CST)

43
Q

What are the pros of open CST?

44
Q

List the cons of open CST technique.

45
Q

What is important to know about using a wound VAC?

46
Q

Describe the endoscopic (CST)

47
Q

List pros of endoscopic component separation technique.

48
Q

List cons of endoscopic component separation technique.

49
Q

Describe remodeling.

50
Q

Describe the importance/benefit of the open collagen structure of XenMatrix

51
Q

Strattice

52
Q

XCM

53
Q

Permacol

54
Q

SurgiSIS

55
Q

Surgimend

56
Q

Veritas

57
Q

Bio A

58
Q

Vicryl

59
Q

TIGR Matrix

60
Q

SeriScaffold

Bard Level 1 Training (3 decks)

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