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聚偏二氟乙烯作为一种用于构建手术网片的新型聚合物。

PVDF as a new polymer for the construction of surgical meshes.

作者信息

Klinge U, Klosterhalfen B, Ottinger A P, Junge K, Schumpelick V

机构信息

Department of Surgery, Technical University of Aachen, Germany.

出版信息

Biomaterials. 2002 Aug;23(16):3487-93. doi: 10.1016/s0142-9612(02)00070-4.

Abstract

Abdominal hernia repair is the most frequently performed operation in surgery. Mostly due to lowered recurrence rates mesh repairs in hernia surgery have become an integral component despite increasing mesh-related complications. Current available mesh prosthesis are made of polypropylene (PP). polyethylene-terephtalat or polytetrafluorethylene. though all of them reveal some disadvantages. The introduction of new materials seems to be advisable. Caused by supposed advantageous textile properties and tissue response two mesh modifications made of polyvinylidene fluoride (PVDF) for abdominal hernia repair were developed. In the present study the PVDF meshes were compared to a common heavy weight PP-mesh (Prolene) in regard to functional consequences and morphological tissue response. After implantation in rats as inlay for 3, 14, 21, 42 and 90 days abdominal wall mobility was recorded by three-dimensional photogrammetry. Tensile strength of the suture zone and the mesh itself were determined. Explanted tissue samples have been investigated for their histological reaction in regard to the inflammatory infiltrate. vascularisation, connective and fat tissue ingrowth. Number of granulocytes, macrophages, fibroblasts, lymphocytes and foreign giant body cells have been evaluated to reflect quality of tissue response. The cellular response was grasped by measurement of DNA strand breaks and apoptosis (TUNEL), proliferation (Ki67) and cell stress (HSP70). Analyzing the results confirmed that construction of hernia meshes made of PVDF could be an advantageous alternative to the commonly used materials due to an improved biostability. lowered bending stiffness and a minimum tissue response.

摘要

腹壁疝修补术是外科手术中最常施行的手术。尽管与补片相关的并发症有所增加,但由于复发率降低,补片修补术已成为疝手术不可或缺的一部分。目前可用的补片假体由聚丙烯(PP)、聚对苯二甲酸乙二酯或聚四氟乙烯制成,不过它们都存在一些缺点。引入新材料似乎是明智之举。由于假定具有有利的纺织性能和组织反应,开发了两种由聚偏二氟乙烯(PVDF)制成的用于腹壁疝修补的补片改良产品。在本研究中,将PVDF补片与一种普通的重磅PP补片(普理灵)在功能影响和形态学组织反应方面进行了比较。在大鼠体内植入作为镶嵌物3、14、21、42和90天后,通过三维摄影测量记录腹壁活动度。测定缝合区和补片本身的拉伸强度。对取出的组织样本进行了组织学反应研究,包括炎症浸润、血管形成、结缔组织和脂肪组织长入。评估粒细胞、巨噬细胞、成纤维细胞、淋巴细胞和异物巨细胞的数量以反映组织反应质量。通过测量DNA链断裂和凋亡(TUNEL)、增殖(Ki67)和细胞应激(HSP70)来把握细胞反应。分析结果证实,由于生物稳定性提高、弯曲刚度降低和组织反应最小,由PVDF制成的疝补片结构可能是常用材料的一种有利替代品。

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