Search Results (358)

Background: Chronic postoperative inguinal pain [CPIP] is a prevalent and often debilitating complication following inguinal hernia repair. With the widespread adoption of mesh-based techniques, recurrence rates have significantly declined, shifting clinical focus toward postoperative pain management. Methods: This narrative review synthesizes international literature on CPIP incidence, surgical technique, geographic variation, and the distinction between neuropathic and nociceptive pain. Studies were selected based on relevance, sample size, and inclusion of pain subclassification. Results: CPIP incidence varies markedly across studies (6–64.3%), influenced by follow-up duration, surgical approach, and regional healthcare practices. The risk of CPIP varies significantly, depending on the surgical technique employed, with open repairs generally associated with higher rates than laparoscopic approaches. Neuropathic pain predominates in specific cohorts, particularly following open repairs with limited nerve preservation. Few studies differentiate pain types, revealing a critical gap in diagnostic precision. Conclusions: CPIP is a multifactorial and under-recognized problem in clinical practice. The adoption of standardized diagnostic tools and long-term follow-up protocols is essential to improve pain classification and management. A structured diagnostic algorithm may assist clinicians in distinguishing pain types and tailoring treatment strategies to individual patient profiles. Full article

Pelvic organ prolapse (POP) cases have been rising, affecting women’s quality of life. Severe cases often require surgical mesh implants, which can cause complications like tissue erosion and infection, leading the FDA to ban transvaginal meshes for POP. To address this, polycaprolactone (PCL) mesh implants, produced via melt electrowriting (MEW), were evaluated mechanically and coated with azithromycin, an antibiotic for genitourinary infections. Uniaxial tensile and cyclic tests assessed the long-term behavior of the meshes over 100 cycles. The results show that while all PCL meshes had similar behavior, those with 1 mm pores sustained higher stress, whereas 1.5 mm pore size meshes had mechanical properties closer to vaginal tissue but remained stiffer. Cyclic tests revealed initial damage and hardening during plastic deformation, with tensile tests confirming increased stiffness, as Young’s modulus rose between 19.2% and 29.3%. Zone inhibition and biofilm assays evaluated azithromycin’s effectiveness against bacterial infection. Even though FTIR analysis could not confirm antibiotic incorporation, the drug coated meshes show inhibitory activity against E. coli biofilm formation and MSSA in its planktonic state. Scanning Electron Microscopy supported these findings. These results suggest that MEW-fabricated PCL meshes coated with azithromycin hold promise as improved implants for POP treatment. Full article

Background/Objectives: Guided bone regeneration one of the most widely used techniques, relies on combining bone graft material with barrier membranes or meshes. The choice of the mesh material depends on the specific clinical situation. Among the available options, titanium membranes are recognized as one of the most effective in dental implantology. The latter can be categorized into two groups: commercial and individualized. Advancements in additive manufacturing make customized titanium meshes an attractive option for bone regeneration. Customized titanium meshes can be manufactured using three main methods: selective laser sintering (SLS), selective laser melting (SLM), and direct metal laser sintering (DMLS). This review aims to provide information about the differences between the production process and the clinical outcomes. Methods: This systematic review was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR). Relevant articles were sought out in the Web of Science, PubMed, and Scopus databases. Results: A total of ten articles were included and thoroughly reviewed. The type of bone graft used, the manufacturing technique, the amount of bone gain, the healing time, and the intraoperative and postoperative complications are discussed. Conclusions: All the relevant studies demonstrated good and predictable results using augmentation with individualized titanium meshes manufactured via SLS, SLM, or DMLS methods. Full article

Background/Objectives: The breast implant exchange/explantation rate has been increasing in recent years due to various types of long-term complications or adverse effects, such as implant migration, rippling, or capsular contracture. To reduce complications such as migration and/or implant–pocket mismatch, surgical meshes may provide implant support. Here, we present a case series about the use of a non-absorbable synthetic bra-shaped mesh in revision surgery of the breast, using implants that do not adhere to the surrounding tissues. Methods: In this retrospective case series, eight patients underwent breast revision surgery between 2021 and 2024 due to implant-related long-term complications following aesthetic surgery. Surgical revision included implant exchange, total or partial capsulectomy, creation of a pre-pectoral implant pocket for the new implant, and positioning of the non-absorbable synthetic mesh, acting as an internal support for the implants. BREAST-Qs were collected from all patients. Results: Of the eight patients included, the following symptoms were observed: symptomatic capsular contracture (n = 3), implant migration (n = 4), and breast animation deformity (n = 2). After revision surgery, during the follow-up period of 6–42 months, neither infection nor seroma occurred. No implant-related complications were registered. The BREAST-Q analysis revealed the highest patient satisfaction in the domain “satisfaction with the implants” (median score 87.5%). Conclusions: In revision surgery after breast augmentation, the synthetic, non-absorbable and titanized pocket-like mesh may provide implant support and avoid recurrence of complications related to implant position. However, due to the small and heterogeneous patient group, larger studies are needed to validate these preliminary findings. Full article

Despite significant advancements, prosthetic hernia repair continues to face unacceptably high complication rates. These likely stem from poor biological responses, such as stiff scar tissue leading to mesh shrinkage. To overcome these issues, the Stenting and Shielding (S&S) Hernia System, a newly designed 3D dynamic device, has been developed for dissection-free laparoscopic placement to permanently obliterate hernia defects. Unlike conventional meshes, this device induces a regenerative biological response, promoting viable tissue growth rather than fibrotic plaque formation. In a porcine experimental model, the S&S device demonstrated the development of a great amount of muscle fibers, alongside nervous and vascular structures, within well-perfused connective tissue. Histological analysis of biopsy specimens excised from the experimental animals revealed progressive muscle fiber maturation from early myocyte development in the short term to fully developed muscle bundles in the long term. The enhanced biological response observed with the S&S device suggests a promising shift in hernia repair, potentially reversing the degenerative processes of hernia formation and promoting tissue regeneration. The S&S Hernia System described here can be classified not merely as a conventional hernia implant, but as part of a new category of hernia devices: the dynamic regenerative scaffold. Full article

Introduction: Guided bone regeneration (GBR) is a key approach for managing alveolar ridge defects. Although titanium meshes are widely used for non-resorbable space maintenance, their limitations have prompted interest in alternative materials. Polyetheretherketone (PEEK), a high-performance thermoplastic, has emerged as a potential barrier due to its mechanical strength, radiolucency, and compatibility with digital workflows. Objective: To map the current evidence on the use of PEEK barriers in GBR, focusing on biological performance, mechanical properties, and clinical outcomes in animal and human studies. Methods: A scoping review was conducted following PRISMA-ScR guidelines. Eligible studies included in vivo animal models or clinical trials involving PEEK barriers for alveolar bone regeneration. Data on study design, defect type, barrier characteristics, surgical protocol, outcomes, and complications were extracted. Results: Five studies met the inclusion criteria: two animal models and three clinical trials. All reported successful space maintenance and bone gain with PEEK barriers, with outcomes comparable to titanium meshes. Customization through CAD/CAM or 3D printing was common. Complications such as soft tissue dehiscence and exposure occurred but generally did not affect regeneration. Evidence was limited by small sample sizes, short follow-up, and single-center designs. Conclusions: PEEK barriers show promise as customizable alternatives to traditional GBR membranes. However, current evidence is limited and geographically concentrated. Future multicenter studies with long-term follow-up and standardized outcome measures are needed to validate the clinical potential of PEEK in bone regeneration. Full article

Background: Peripherally inserted central catheters (PICCs) are becoming an increasingly utilised alternative to traditional central venous access devices. Their uptake, particularly among oncology patients, is due to their growing ease of access, suitability for medium-term use and perceived safety profile. However, PICCs can be a source of severe and life-threatening complications such as central line-associated bloodstream infection (CLABSI), deep vein thrombosis (DVT), pulmonary embolism (PE), malpositioning, dislodgement, and occlusion. Methods: This narrative was constructed from a literature review of the PubMed database, utilising MESH terms for peripherally inserted central catheters, percutaneous central catheters, PICC, and complications. Randomised controlled trials, systematic reviews, and meta-analyses published between 2015 and 2025 were included. Additional articles were obtained through targeted PubMed searches or from references within previous articles. Results: Major periprocedural complications were seen in 1.1% of PICC insertions, CLABSI in 1.4–1.9%, venous thrombosis embolism (including PE) in 2.3–5.9%, and malpositioning in 7.87%. The overall PICC complication incidence was 9.5–38.6%, which is greater than that of centrally inserted central venous access. A higher BMI, diabetes mellitus, chronic renal failure, and malignancy were the most significant predictive factors for PICC-associated complications. Conclusions: PICC complications are common, occurring more frequently than other forms of central venous access, and may lead to significant morbidity and mortality. Appropriate assessment of patient risk factors and optimisation strategies may reduce complication rates. Full article

Background/Objectives: In the search for optimal meshes and matrices in breast surgery, poly-4-hydroxybutyrate (P4HB) has emerged as a promising alternative. This review evaluates the clinical application of P4HB scaffolds, focusing on complication rates and surgical outcomes. Methods: A systematic search was conducted using PubMed and ScienceDirect. Clinical studies assessing perioperative outcomes and complications associated with P4HB scaffolds in breast surgery were included. Results were stratified into aesthetic and reconstructive surgery categories. Meta-analysis was implemented to assess the rate of complications and satisfaction. Results: This systematic review included 13 studies evaluating the use of P4HB scaffold in breast reconstruction (636 cases) and aesthetic breast surgery (462 patients). Breast reconstruction studies were all retrospective, mainly reporting two-stage, prepectoral, immediate reconstructions. Aesthetic studies included both prospective and retrospective designs, with varied implant planes and incision patterns. P4HB use was associated with high satisfaction (95.5%) and favorable outcomes, including lower odds of wound complications (log-OR = −1.135, p = 0.003). Complication rates were low across both surgical categories. P4HB scaffold showed promise in supporting implant-based procedures and maintaining breast shape over time, with minimal increase in surgical time and stable anthropometric measurements. Conclusions: The use of P4HB scaffold in breast reconstruction and aesthetic surgery shows promising results, notably in reducing wound-related complications. Breast reconstruction studies report low complication rates and favorable patient-reported outcomes. In aesthetic procedures, P4HB contributes to improved long-term breast shape and high satisfaction. Despite encouraging findings, further research is necessary to validate long-term efficacy and refine surgical approaches. Full article

Pelvic organ prolapse (POP) is a prevalent condition, affecting women all over the world, and is commonly treated through surgical interventions that present limitations such as recurrence or complications associated with synthetic meshes. In this study, biodegradable poly($ϵ$-caprolactone) (PCL) cog threads are proposed as a minimally invasive alternative for vaginal wall reinforcement. A custom cutting tool was developed to fabricate threads with varying barb angles (90°, 75°, 60°, and 45°), which were produced via Melt Electrowriting. Their mechanical behavior was assessed through uniaxial tensile tests and validated using finite element simulations. The results showed that barb orientation had minimal influence on tensile performance. In simulations of anterior vaginal wall deformation under cough pressure, all cog thread configurations significantly reduced displacement in the damaged tissue model, achieving values comparable to or even lower than those of healthy tissue. A ball burst simulation using an anatomically accurate model further demonstrated a 13% increase in reaction force with cog thread reinforcement. Despite fabrication limitations, this study supports the biomechanical potential of 3D-printed PCL cog threads for POP treatment, and lays the groundwork for future in vivo validation. Full article

Background/Objectives: This case study presents the first documented use of a low-cost, simulated, patient-specific three-dimensional (3D) printed model to support presurgical planning for an infant with Apert syndrome in a resource-limited setting. The primary objectives are to (1) demonstrate the value of 3D printing as a simulation tool for preoperative planning in low-resource environments and (2) identify opportunities for future AI-enhanced simulation models in craniofacial surgical planning. Methods: High-resolution CT data were segmented using InVesalius 3, with mesh refinement performed in ANSYS SpaceClaim (version 2021). The cranial model was fabricated using fused deposition modeling (FDM) on a Creality Ender-3 printer with Acrylonitrile Butadiene Styrene (ABS) filament. Results: The resulting 3D-printed simulated model enabled the surgical team to assess cranial anatomy, simulate incision placement, and rehearse osteotomies. These steps contributed to a reduction in operative time and fewer complications during surgery. Conclusions: This case demonstrates the value of accessible 3D printing as a simulation tool in surgical planning within low-resource settings. Building on this success, the study highlights potential points for AI integration, such as automated image segmentation and model reconstruction, to increase efficiency and scalability in future 3D-printed simulation models. Full article

Hernia is a physiological condition that significantly impacts patients’ quality of life. Surgical treatment for hernias often involves the use of specialized meshes to support the abdominal wall. While this method is highly effective, it frequently leads to complications such as pain, infections, inflammation, adhesions, and even the need for revision surgeries. According to the Food and Drug Administration (FDA), hernia recurrence rates can reach up to 11%, surgical site infections occur in up to 21% of cases, and chronic pain incidence ranges from 0.3% to 68%. These statistics highlight the urgent need to improve mesh technologies to minimize such complications. The design and material composition of meshes are critical in reducing postoperative complications. Moreover, integrating drug-eluting properties into the meshes could address issues like infections and inflammation by enabling localized delivery of antibiotics and anti-inflammatory agents. Mesh design is equally important, with innovative structures like auxetic designs offering enhanced mechanical properties, flexibility, and tissue integration. These advanced designs can distribute stress more evenly, reduce fatigue, and improve performance in areas subjected to high pressures, such as during intense coughing, sneezing, or heavy lifting. Technological advancements, such as 3D printing, enable the precise fabrication of meshes with tailored designs and properties, providing new opportunities for innovation. By addressing these challenges, the development of next-generation mesh implants has the potential to reduce complications, improve patient outcomes, and significantly enhance quality of life for individuals undergoing hernia repair. Full article

Background and Objectives: Incisional hernia is a common complication following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). This study aimed to identify patient and surgical factors associated with its occurrence. Materials and Methods: We conducted a retrospective analysis of 122 patients undergoing CRS and HIPEC. Logistic regression models were applied to identify predictors of incisional hernia development. Results: Incisional hernia occurred in 23.8% of patients. Hypertension was identified as an independent factor associated with increased risk. Peritoneal Cancer Index (PCI), operative time, and abdominal wall closure technique were not found to be significantly associated with hernia development. Conclusions: Preoperative identification of high-risk patients may support the adoption of targeted preventive strategies, including prophylactic mesh placement and enhanced postoperative surveillance. Full article

Island electrical networks often face stability and resilience issues due to their weakly meshed structure, which lowers system inertia and compromises supply continuity. This challenge is further intensified by the increasing integration of renewable energy sources, promoted by decarbonization goals, whose intermittent and variable nature complicates grid stability management. To address this, Red Eléctrica de España—the transmission system operator of Spain—has planned several improvements in the Canary Islands, including the installation of new wind farms and a second transmission circuit on the island of La Palma. This new infrastructure will complement the existing one and ensure system stability in the event of N-1 contingencies. This article evaluates the stability of the island’s electrical network through dynamic simulations conducted in PSS^®E, analyzing four distinct fault scenarios across three different grid configurations (current, short-term upgrade and long-term upgrade with wind integration). Generator models are based on standard dynamic parameters (WECC) and calibrated load factors using real data from the day of peak demand in 2021. Results confirm that the planned developments ensure stable system operation under severe contingencies, while the integration of wind power leads to a 33% reduction in diesel generation, contributing to improved environmental and operational performance. Full article

Creating high-fidelity digital twins (DTs) for Industry 4.0 applications, it is fundamentally reliant on the accurate 3D modeling of physical assets, a task complicated by the inherent imperfections of real-world point cloud data. This paper addresses the challenge of reconstructing accurate, watertight, and topologically sound 3D meshes from sparse, noisy, and incomplete point clouds acquired in complex industrial environments. We introduce a robust two-stage completion-to-reconstruction framework, C2R3D-Net, that systematically tackles this problem. The methodology first employs a pretrained, self-supervised point cloud completion network to infer a dense and structurally coherent geometric representation from degraded inputs. Subsequently, a novel adaptive surface reconstruction network generates the final high-fidelity mesh. This network features a hybrid encoder (FKAConv-LSA-DC), which integrates fixed-kernel and deformable convolutions with local self-attention to robustly capture both coarse geometry and fine details, and a boundary-aware multi-head interpolation decoder, which explicitly models sharp edges and thin structures to preserve geometric fidelity. Comprehensive experiments on the large-scale synthetic ShapeNet benchmark demonstrate state-of-the-art performance across all standard metrics. Crucially, we validate the framework’s strong zero-shot generalization capability by deploying the model—trained exclusively on synthetic data—to reconstruct complex assets from a custom-collected industrial dataset without any additional fine-tuning. The results confirm the method’s suitability as a robust and scalable approach for 3D asset modeling, a critical enabling step for creating high-fidelity DTs in demanding, unseen industrial settings. Full article

Carrier-based aircraft recovery is a critical and challenging phase in maritime operations due to the turbulent airwake generated by aircraft carriers, which significantly increases the workload of flight control systems and pilots. This study investigates the airwake effects of an aircraft carrier under varying wind direction conditions. A high-fidelity mathematical model combining delayed detached-eddy simulation (DDES) with the overset grid method was developed to analyze key flow characteristics, including upwash, downwash, and lateral recirculation. The model ensures precise control of aircraft speed and trajectory during landing while maintaining numerical stability through rigorous mesh optimization. The results indicate that the minimum lift occurs in the downwash region aft of the deck, marking it as the most hazardous zone during landing. Aircraft above the deck are primarily influenced by ground effects, causing a sudden increase in lift that complicates arresting wire engagement. Additionally, the side force on the aircraft undergoes an abrupt reversal during the approach phase. The dual overset mesh technique effectively captures the coupled motion of the hull and aircraft, revealing higher turbulence intensity along the glideslope and a wider range of lift fluctuations compared to stationary hull conditions. These findings provide valuable insights for optimizing carrier-based aircraft recovery procedures, offering more realistic data for simulation training and enhancing pilot preparedness for airwake-induced disturbances. Full article