Use Of Gore-Tex Research Articles

Safety and Efficacy of Non- and Minimally Irradiated Homologous Costal Cartilage in Primary and Revision Rhinoplasty.

Importance: Despite favorable results with conventionally irradiated homologous costal cartilage, there have been no clinical studies to date evaluating the utility of non- or minimally irradiated homologous costal cartilage (NIHCC) in rhinoplasty. Objective: To evaluate the safety and efficacy of NIHCC in primary and revision rhinoplasty. Design, Setting, and Participants: We conducted a retrospective medical record review of patients undergoing primary and revision rhinoplasty between January 2010 and December 2014. Twenty-six patients who underwent primary or revision rhinoplasty with NIHCC were identified. Patient follow-up ranged from 2 to 43.2 months (mean 15.9 months) at the study took place in a single-center private practice, and surgery was performed by the two senior authors. Twenty-seven consecutive patients who underwent primary or revision rhinoplasty for functional and/or cosmetic concerns with NIHCC were identified. One patient was excluded due to concomitant use of GORE-TEX, leaving 26 patients for retrospective review. Seven patients underwent primary rhinoplasty and 19 patients underwent revision rhinoplasty. Main Outcomes and Measures: The purpose of this study is to demonstrate whether non- or minimally irradiated homologous rib cartilage used for primary and revision rhinoplasty has acceptable rates of warping, resorption, and infection. Results: A total of 26 patients underwent surgery with NIHCC; 20 (77%) were women, and the average patient age was 42 years (median 45 years). A total of 100 NIHCC grafts were used. Seven patients underwent primary rhinoplasty and 19 (73%) patients underwent revision rhinoplasty. The total complication rate related to grafts was 3.6%, which included 2 cases of partial noninfective resorption of 77 palpable or superficial grafts (2.6%), 1 infection of 100 grafts (1.0%), and zero cases of graft mobility and warping. Conclusion and Relevance: Non- or minimally irradiated homologous costal cartilage is safe and effective for grafting in primary and revision rhinoplasty, with low rates of resorption, infection, mobility, and warping. Further larger studies will need to be conducted to determine whether or not the reduced radiation improves outcomes compared with traditionally radiated homologous cartilage.

Revisiting the Use of GORE-TEX as an Interpositional Material in Surgical Management of Severe Temporomandibular Joint Ankylosis.

(1) Defining a protocol for management of patients with severe temporomandibular joint ankylosis. (2) Review the results of use of GORE-TEX as an interpositional material in gap arthroplasty. All cases which were treated with surgical intervention for severe TMJ Ankylosis with use of GORE-TEX as an interpositional material have been included. Amongst 40 patients, 11 were male and 29 were female with age group ranging from 4 to 36years. 22 patients had bilateral ankylosis and 18 patients had unilateral ankylosis needing unilateral condylectomy. In all the patients GORE-TEX was used as an inter-positional material to form a pseudo joint. Postoperative mouth opening was around 3 fingers (3-3.5cm) for period of 2years i.e. last follow up. Migration or extrusion of implant was not seen in any of our cases. Use of GORE-TEX as an inter-positional material can prevent recurrences with good restoration of the physiological joint and occlusion.

Solvent Vapour Use – The Unintended Consequences in Textile Conservation

ABSTRACTThe impact of solvent vapour from two solvents, acetone and industrial denatured alcohol (IDA), commonly used in adhesive reactivation in textile conservation, when applied to artificially soiled silk fabric through either Gore-Tex® or Reemay® membranes for exposure times of either 1 or 3 min, was measured using microscopy and ImageJ to monitor the movement of the solid particulates of the soiling, and Fourier transform infrared spectroscopy with attenuated total reflectance (FTIR-ATR) to monitor the movement of the oily components. Analysis using these techniques successfully showed the movement of large particulates through the textile and a decrease in the presence of oil. Analysis with FTIR-ATR showed that the application of solvent vapour by a poultice method produces more than just a surface change and the vapour can penetrate far enough into the fibres to cause a change in the level of oil through the entire textile. The results showed that the solvents and barrier membranes have characteristic differences which impact on the changes on the soiling. The application of acetone produced a greater change in the movement of oil on the front and back of the samples than the application of IDA, while a comparison between the barrier membranes showed a greater change occurring in the level of oil with the use of Gore-Tex® rather than Reemay®. The time of exposure to solvent vapour made little difference to the changes to the textile soiling. Quantitatively significant results were gathered from analysis of the changes in the oil measured with FTIR-ATR, and qualitative changes in the large particulate soiling, demonstrating the potential usefulness of ImageJ open access software in future historic textile soiling monitoring studies.

Development of a wearable electrochemical sensor for voltammetric determination of chloride ions

This work describes the development of a disposable and wearable screen-printed electrochemical sensor for the determination of chloride ions. The sensor includes three screen-printed electrodes: a working, an auxiliary (both carbon paste electrodes), and an Ag/AgCl pseudo-reference electrode. The sensor works by measuring the Nernstian shift of the voltammetric peak potential of ferrocenemethanol in the presence of chloride ions, due to the use of a pseudo-reference electrode in the electrodic system. The measurements are easily taken by dropping the sample onto the electrodic surface.Different flexible materials, including textiles, were studied as substrates of the electrodic system. A study of ink adherence and conductivity in these materials was carried out. The use of Gore-Tex® displayed good ink adherence, acceptable conductivity and waterproof properties. These features make it an excellent support for wearable sensors.The reproducibility and repeatability, in terms of relative standard deviation values of the developed Gore-Tex sensor, were below 3% (n=5) and the detection limit was 0.2mM (α=β=0.05).The sensor was successfully applied to determine the chloride content in sea water.

Cranioplasty and Duraplasty with Transcranial Color-Coded Duplex Sonography after Aneurysmal Subarachnoid Hemorrhage

Transcranial color-coded duplex sonography (TCCS) is a noninvasive technique for monitoring of cerebral vasospasm after neurosurgery for aneurismal subarachnoid hemorrhage. In this surgery, surgical materials are used. The goal of the study was to identify materials that can be used with ultrasound and to propose methods for cranioplasty and duraplasty using materials that permit TCCS. The chosen neurosurgical materials were titanium mesh plate (TMP), Gore-tex, SEAMDURA, gelatinous sponge, and oxidized cellulose. B-mode imaging was recorded with the materials placed between urethane resin 10 mm in diameter and the urethane phantom model. TCCS was performed to detect middle cerebral artery flow through TMP and Gore-tex. TMP and SEAMDURA permitted penetration of ultrasound in B-mode and Doppler imaging, but the other materials did not do so. A postcraniotomy window (PCW) on a line extending from the horizontal portion of M1 using only TMP permitted flow imaging with TCCS. In external decompression, TCCS was effective only without use of Gore-tex around the postcraniotomy window. This method allows the middle cerebral artery flow to be detected easily.

Comparison of infectious complications with synthetic mesh in ventral hernia repair

BackgroundInfection can be a devastating complication associated with prosthetic incisional hernia repair. It is unclear whether the type of mesh used affects the risk of infection. MethodsA retrospective review was performed of all patients who underwent elective incisional hernia repair with permanent prosthetic mesh between January 1, 2000, and August 1, 2007. ResultsA total of 176 patients underwent elective incisional hernia repair with mesh. The overall infection rate with the use of goretex (Flagstaff, AZ, USA) was 12 of 86 (14%) and 2 of 90 (2.2%) in cases in which nongoretex material was used (P = .016). In the goretex group, infection rates were significantly higher in open versus laparoscopic cases (26.5% vs 5.8%, P = .030). Methicillin-resistant Staphylococcus aureus was the most common organism recovered. ConclusionsThe risk of mesh infection with the use of goretex was found to be higher than with the use of nongoretex mesh. Laparoscopic placement of goretex reduces this risk of infection. No significant differences in recurrence rates were found.

Gore-Tex Nasal Augmentation

Gore-Tex Nasal Augmentation

Orbital surgery – a two year audit of practice in a craniofacial centre

Background: The surgical techniques and materials used in orbital reconstructive surgery vary widely. The choice of methodand material for a given case often depend on the preferences and experience of the surgeon. Periodic audit of practice isdesirable to evaluate the successes and failure in a center and to compare experiences with other centers.Objective: This study was undertaken to review the indications, surgical approaches, methods and materials used for orbitalreconstruction/recontouring and the incidence and type of complications of the surgery at our centre.Materials and method: The clinic database was explored to retrieve the records of patients who had orbital surgery betweenMay 1, 2005 and April 30, 2007. The required information were retrieved and tabulated to review the current indications,techniques and outcome of orbital surgery at the center.Result: There were 11 patients involved in the audit including 9 males and 2 females within the age range of 10-60 years, meanage of 25.6 + SD 13.1 years. Trauma was the most frequent indication for surgery, the coronal and transconjunctiva approach tothe orbits were favoured and cranial bone graft and Goretex were the preferred materials for reconstruction. Ocular and nonocular postoperative complications were observed. Many of the patients involved had delayed primary or secondary interventionin which case the quality of treatment outcome was affected and further operations were required to correct residual symptomsand complicationsConclusion: Although, there are many complex techniques and esoteric materials being employed worldwide, the approach inthis center is a simplistic one with preference for autogeneous calvarial bone graft and use of Gore-Tex where alloplastic materialwas considered adequate. These principles have been adopted with considerable success.

Medialization laryngoplasty with Gore-Tex for voice restoration secondary to glottal incompetence: indications and observations.

Gore-Tex has been used as an effective implant for medialization laryngoplasty in the management of paralytic dysphonia; however, reporting of large patient cohorts has been limited. Furthermore, the use of Gore-Tex in the treatment of glottal incompetence secondary to soft tissue defects has not yet been described. Finally, a number of the procedural nuances of using Gore-Tex have not been elucidated. A prospective investigation was done on 142 patients who underwent 152 Gore-Tex medialization laryngoplasties in 183 vocal folds from December 1997 to March 2002. The primary diagnoses prompting the 152 procedures were paralysis in 94, paresis in 18, cancer reconstruction in 14, sulcus vocalis in 6, atrophy in 3, trauma defect in 5, arytenoid dislocation in 3, bilateral paralysis in 3, bilateral paresis in 1, parkinsonism in 4, and neurologic aerodynamic dissociation in 1. One patient who underwent reconstruction of a complex cancer defect required endoscopic removal of the Gore-Tex because of persistent granulation. Clinical observations reveal that Gore-Tex is a versatile implant that is ideally suited for phonosurgical reconstruction of aerodynamic glottal incompetence secondary to a variety of causes. Gore-Tex was especially useful for medialization of complex anatomic soft tissue defects such as those resulting from cancer resection, trauma, atrophy, and sulcus vocalis. There was superior ease in handling, placement, and in vivo adjustability.

Hepatic vein reconstruction for resection of hepatic tumors.

Involvement of the hepatic veins requiring reconstruction has traditionally been considered a contraindication to resection for advanced tumors of the liver because the surgical risks are high and the long-term prognosis poor. Recent advances in liver surgery gleaned from split and live donor liver transplantation that necessitate hepatic vein reconstruction can be applied to hepatic resection in some cases. Sixteen patients who underwent hepatic resection requiring hepatic vein reconstruction from 1996-2001 were reviewed. The mean age was 43 years (range 2-61). Nine patients were resected for hepatocellular carcinoma (HCC), five patients for colorectal metastases, and one patient each for hepatoblastoma and cholangiocarcinoma. In six patients with HCC and cirrhosis, the right hepatic vein was reconstructed to provide venous outflow to liver segments not adequately drained by a remaining major hepatic vein. Four of these six patients required the use of Gore-Tex (W. L. Gore & Associates, Inc., Newark, DE) interposition grafts. In the 10 other cases the entire venous outflow from the remnant liver was reconstructed or reimplanted into the inferior vena cava primarily (n = 8) or using segments of the portal vein from the resected side of the liver as a graft (n = 2). Ex-vivo procedures with the use of veno-venous bypass were required in two cases and in-situ cold perfusion of the liver was used in one case. There were two perioperative deaths (12%). One patient died of liver failure 3 weeks after right trisegmentectomy with reconstruction of the left hepatic vein and one patient died at 3 months after resection due to sepsis from a segment of small bowel that perforated into a diaphragmatic hernia. Four patients had evidence of postoperative liver failure that resolved with supportive management and one patient required temporary dialysis. All vascular reconstructions were patent at last followup. With median followup of 23 months, 3 patients have died of recurrent malignancy at 14, 18 and 30 months, while an additional patient went on to die of progressive liver failure at 22 months. Actuarial 1 and 3 year survival was 88% and 50% respectively. Hepatic vein involvement by hepatic malignancy does not necessarily preclude resection. Liver resection with reconstruction of the hepatic veins can be performed in selected cases. The increased risk associated with the procedure appears to be balanced by the possible benefits, particularly when the lack of alternative curative approaches is considered.

Augmentation of the nasal dorsum using Gore-Tex: intermediate results of a retrospective analysis of experience in 66 patients.

Out of the numerous implant materials that have been used for augmentation of the nasal dorsum, autogenous cartilage is considered to be the optimal grafting material due to its versatility and long-term survival. However, in the case of extensive augmentation often an alternative grafting material is needed. Homologous cartilage seems an attractive option, but is not commonly used because of the fear of disease transmission, the long-term unpredictability and the possibility of warping. Alloplastic grafts have offered varying degrees of success in rhinoplasty, but have resulted in significant complications as well. Lately, expanded polytetrafluorethylene (Gore-Tex(R)) has proven to be a promising synthetic material in nasal dorsal augmentation. However, convincing long-term success compared to autogenous cartilage grafts is still lacking and numbers are insufficient. This paper consists of a prelimary report about the use of Gore-Tex(R) soft-tissue patches in nasal dorsal augmentation in 66 patients over a 6-year period, which forms the largest European series so far. No complications were observed in either primary (29%) or revision rhinoplasties (71%).

Use of Gore-Tex tubing as a conduit for inferior alveolar and lingual nerve repair: Experience with 6 cases

Purpose: This report evaluates treatment outcomes associated with the use of Gore-Tex (GT; W.L. Gore & Associates, Flagstaff, AZ) vein graft tubing as a conduit for repair of inferior alveolar nerve (IAN) and lingual nerve (LN) continuity defects. Patients and Methods: Six patients (5 female and 1 male) with painful dysesthesia secondary to injuries of the IAN (n = 3) or LN (n = 3) underwent surgical exploration and resection of pathologic tissue. Reconstruction of the resultant continuity defects was performed using 3-mm diameter GT tubing sutured to the epineurium of the proximal and distal nerve trunks. Nerve reconstruction was performed an average of 20 months after injury (range, 4 to 48 months). Patients were tested before and after surgery with the following tests: subjective pain level using an analogue scale, sharp stimulus, touch, cold sensation, directional sense, and 2-point discrimination. Results: Four patients reported no change in subjective pain level, and 2 patients had minimal decrease in pain. Two patients reported some sensation to sharp stimulus, and 1 patient was hypersensitive. Three patients responded to touch, and 3 had no response. Four patients had no response to cold senstation, and 2 had a delayed response. Only 1 patient could detect brushstroke direction. Three patients had no response to 2-point discrimination, and 3 responded at greater than 20 mm. Conclusions: Use of GT tubing in this group of patients produced poor clinical outcomes and is not recommended for nerve reconstruction of IAN and LN continuity defects. © 2001 American Association of Oral and Maxillofacial Surgeons

Modified pericardial closure technique in patients with ventricular assist device

The use of Gore-Tex (W.L. Gore & Assoc, Flagstaff, AZ) sheet for pericardial closure in patients with left ventricular assist device as a bridge to transplant allows easy dissection of epicardial adhesions and safe resternotomy at the moment of heart transplantation, with no complications or significant cost increase related to the Gore-Tex itself.

Vermilion Border Cheiloplasty

The aging process is, in part, characterized by thinning lips, This is antithetical to our culture, which idolizes youth and the plump, full lips associated with youthfulness. Because the appearance of aging lips is not desirable, and many times aging face techniques accentuate the thinning, techniques have been developed to augment aging oral labia. Substances such as fat tissue and bovine collagen are among the choices for use in injectable augmentation. Use of these products will temporarily fill thinning, wrinkled lips, as well as other perioral structures. The use of Gore-Tex provides more permanent enhancement, but is limited as to results. Vermilion border cheiloplasty is a permanent surgical procedure to augment labial tissue that can create lips of virtually any size or shape, as well as excise perioral rhytids. Herein we review 65 lip-lifts (cheiloplasty), with or without corner lifts, where the incision extends beyond commissure. These procedures may be performed together or independently on both the upper and lower labia. However, poor scar formation, asymmetries, and prolonged healing make this a procedure for those who fail lesser techniques.

USE OF GORE-TEX

USE OF GORE-TEX

The use of Gore-Tex for nasal augmentation: a retrospective analysis of 106 patients: T. G. Owsley, C O. Taylor. Plast Reconstr Surg 1994; 94: 241–248. (Discussion by R.K. Daniel, pp 249–250)

The use of Gore-Tex for nasal augmentation: a retrospective analysis of 106 patients: T. G. Owsley, C O. Taylor. Plast Reconstr Surg 1994; 94: 241–248. (Discussion by R.K. Daniel, pp 249–250)

The Use of Expanded Polytetrafluoroethylene (Gore-Tex) in Rhinoplasty: A 6-Year Experience

To determine the safety and efficacy of expanded polytetrafluoroethylene (Gore-Tex soft-tissue patch, W. L. Gore & Assoc Inc, Flagstaff, Ariz) as an implant in rhinoplasty. A retrospective study of 137 patients who underwent rhinoplasty including augmentation with Gore-Tex over a 6-year period. A review of the medical literature concerning the use of Gore-Tex as an implant in the head and neck was also conducted. Two major academic medical centers and two private office surgical centers. One hundred thirty-seven consecutive patients who received Gore-Tex implants in the course of rhinoplasty. Sixty-nine patients presented for primary rhinoplasty; the remaining 68 presented for revision surgery. All received Gore-Tex nasal implants to augment the nasal dorsum and/or base. The grafts ranged from 1 to 6 mm in thickness. Follow-up ranged from 6 to 80 months, with an average of 25 months. Clinically noted complications and patient satisfaction. Three (2.2%) of 137 grafts became infected and were removed. One graft was removed 5 months post-operatively because of excessive augmentation. None of the patients who underwent implant removal required subsequent augmentation. All 137 patients are pleased with their results. Gore-Tex is a safe and effective implant material to use in primary and revision rhinoplasty when augmentation is needed and autogenous material is not available or desirable.

Subcutaneous Implantation Of Gore-Tex For Facial Reconstruction

Subcutaneous implantation of Gore-Tex for facial reconstruction allows physicians to recontour the soft tissues of the face and to augment areas that are deficient of subcutaneous tissue for genetic, aging, and traumatic reasons. This article discusses the use of Gore-Tex in multiple implant sites and presents novel ideas for both facial and cervical augmentation.

The Use of Gore-Tex for Nasal Augmentation

The Use of Gore-Tex for Nasal Augmentation

The Use of Gore-Tex for Nasal Augmentation

Numerous implant materials have been used in nasal surgery, including autogenous, homogeneous, and alloplastic grafts. Autogenous cartilage remains the ideal graft material; however, situations exist where an alternative or an additional grafting material is needed. Homogeneous materials have demonstrated significant resorption. Alloplastic grafts have offered varying degrees of success but have resulted in significant complications as well. Gore-Tex has undergone extensive research and clinical application in various surgical fields with reported success. This analysis examines 106 patients over a 5-year time period in which the Gore-Tex soft-tissue patch was used in a wide variety of situations from extensive nasal dorsal reconstruction to small localized nasal defects or irregularities. Postoperative follow-up has revealed a stable implant material with no complications relating to the graft material.