Prolene 2 0

For open sublay hernia repair, the skin incision was made above the hernia, and the hernia sack was mobilized. After repositioning of the hernia, the rectus sheet was opened on both sides, and the posterior layer of the rectus sheet was dissected away from the rectus abdominis muscle. The dissection was extended laterally to the linea semilunaris to facilitate a mesh overlap of at least 5 cm to each site. Next, the posterior layer of the rectus sheet was closed by a running suture (Prolene™ 2–0, Ethicon GmbH, Norderstedt, Germany). The mesh (Ultrapro®, Ethicon GmbH, Norderstedt, Germany) was placed in a retromuscular position and fixed with sutures (Prolene™ 2–0, Ethicon GmbH, Norderstedt, Germany). Following this, wound drainage was positioned above the mesh to the surgeon’s discretion, and the anterior layer of the rectus sheet was closed by a running suture (Prolene™ 2–0, Ethicon GmbH, Norderstedt, Germany).

A midline incision was made through the skin from the right and left orbits to the occipital part of the calvaria. The temporalis muscles were subperiosteally elevated from the frontal bone and retracted bilaterally (flap). All remaining soft tissue attached to the bone was sharply dissected to expose the site and prepare the frontal bone for implantation. Two semi‐onlay implants were bilaterally placed on the frontal bone of the skull of each sheep. Each implant was fixed to the frontal bone with two self‐drilling 1.5 × 4 mm bone screws (Medicon, art no: 68.93.24 A) one in each opposite fixation points of the implant, as outlined in Figure 1a, D‐E. Following fixation of the implants, the soft tissues were closed with absorbable sutures (Vicryl^® 2‐0, Ethicon) and the skin was closed with non‐absorbable sutures (Prolene^® 2‐0, Ethicon) and surgical staples. The wounds were disinfected using oxytetracycline (Oxytetrin^® spray, MSD).

After shaving and disinfection, an incision was made above the tuber coxae/anterior edge to the crista iliaca (human anatomical correlate: anterior superior iliac spine) of the iliac crest. Preparation was performed down to the periost and incised. A 3 cm bone graft was harvested from the iliac crest with a saw (Fig. 6e). Hemostasis, periost suture, and wound closure using Prolene 2-0 (Ethicon Inc., Somerville, NJ, USA) were performed.
The surgical site at the tibia was shaved, prepped, and draped for sterility. A longitudinal skin incision was made over the tibia defect site after X-ray control. After dissection of the thin subcutaneous fatty layer, the translucent superficial fascia cruris was exposed and incised. The periost was incised and completely removed at the defect site. Under X-ray control, the tibia defect was planned in the middle aspect of the tibia. The plate was fixed with k-wires under X-ray control and the 3 cm bone defect was created with a saw (Fig. 6f, g). The iliac bone graft was placed in the defect site. The tibia and the bone graft were fixated by the plate and screws (Königsee Implantate, distal femur plate set, titanium, Allendorf, Germany) under X-ray control (Fig. 6h). Hemostasis was assured, a suction drain was inserted, penetrating the sheep’s skin remote to the skin incision, and the wound was closed using Prolene 2-0.