Ballore L, Orrù F, Nicolini F, Contini S A, Galletti G, Gherli T
Cattedra e Divisione di Cardiochirurgia, Università degli Studi, Parma.
Acta Biomed Ateneo Parmense. 2000;71(5):159-66.
Repeat cardiac surgical procedures are associated with increased technical difficulty and risk related to the presence of dense adhesions between the heart and the surrounding tissues. We examined the efficacy of a bioabsorbable membrane containing hyaluronic acid in the prevention of pericardial adhesions in 23 rabbits. After thoracotomy and pericardiotomy the animals were divided in three groups: Group 1 (9 animals) in which the epicardial surfaces were covered by Seprafilm membrane, Group 2 (9 animals) treated with both Seprafilm membrane and Sepracoat solution, and Group 3 (5 animals) as controls. The animals were reexplored at 10, 30 and 60 days: no intrapericardial adhesions were found in all the animals of Group 2. In 4 animals (44%) of Group 1 localized post-operative adhesions were detected, in absence of epicardial hyperplasia; in contrast, dense and diffuse adhesions were present in all the control animals. The use of the bioabsorbable membrane Seprafilm significantly reduces adhesion formation even if better results are possible with the previous intrapericardial administration of Sepracoat solution. Application of these biocompatible products could reduce the technical difficulty and risk of repeat surgical procedures.
再次心脏外科手术与技术难度增加以及因心脏与周围组织之间存在致密粘连而产生的风险相关。我们研究了一种含透明质酸的生物可吸收膜在23只兔子中预防心包粘连的效果。开胸和心包切开术后,将动物分为三组:第1组(9只动物),其心外膜表面覆盖Seprafilm膜;第2组(9只动物),同时用Seprafilm膜和Sepracoat溶液处理;第3组(5只动物)作为对照组。在第10、30和60天对动物进行再次探查:第2组所有动物均未发现心包内粘连。第1组4只动物(44%)检测到局部术后粘连,无心外膜增生;相比之下,所有对照动物均存在致密和弥漫性粘连。生物可吸收膜Seprafilm的使用显著减少了粘连形成,即使在心包内预先使用Sepracoat溶液可能会有更好的效果。应用这些生物相容性产品可以降低再次手术的技术难度和风险。