Continenza Maria Adelaide, Vicentini Carlo, Paradiso-Galatioto Giuseppe, Fileni Antonio, Tchokogoue Eugenie
Institutes of Human Anatomy, Surgical Sciences Department, Medical School of the University of L'Aquila, Italy.
Ital J Anat Embryol. 2003 Oct-Dec;108(4):231-9.
Many different synthetic biomaterials have been recently proposed in the majority of the techniques for hernioplasty and pelvic floor surgery. Required qualities of an implantable prosthetic material have been well established in the past and today the biomaterials better performing to this purpose are the monofilamented Polypropylene (Marlex) and the multifilamented Polyestere (Mersilene). But, in spite of a wide surgical use of these two kinds of meshes, many failures of these implantations are reported leading to removal of the prosthetic implanted material. If some of these failures are due to errors in surgical technique, others seem to be due to inadequacy of the selected material, too much soft or too much stiff, or too much or too little incorporated into the host tissue. This experiment investigated the different behaviour of in vitro cultured Human Dermal Fibroblasts, seeded on specimens of both meshes and then observed by Light (LM) and Scanning Electron Microscopy (SEM). Around the multifilamented threads of Polyestere mesh, fibroblasts could grow very well, filling the holes and making a continous cell layer completely envelopping the mesh. At the same culture time, around the Polypropylene mesh only big groups of fibroblasts were evident at the thread interlacing points. Therefore, it could be concluded that both meshes stimulate good fibroblast attachment and proliferation but in a very different way and amount; it will be up to the surgeon to select the appropriate mesh according to the specific surgical purpose.
最近，在大多数疝修补术和盆底手术技术中，人们提出了许多不同的合成生物材料。过去，对于可植入假体材料所需的特性已有明确规定，如今，在这方面表现更佳的生物材料是单丝聚丙烯（Marlex）和复丝聚酯（Mersilene）。但是，尽管这两种网片在外科手术中被广泛使用，但仍有许多植入失败的报道，导致植入的假体材料被移除。如果其中一些失败是由于手术技术失误造成的，那么其他一些似乎是由于所选材料不合适，要么太软，要么太硬，或者与宿主组织融合得太多或太少。本实验研究了体外培养的人真皮成纤维细胞在两种网片标本上的不同行为，然后通过光镜（LM）和扫描电子显微镜（SEM）进行观察。在聚酯网片的复丝线周围，成纤维细胞可以很好地生长，填充孔洞并形成一个连续的细胞层，完全包裹住网片。在相同的培养时间，在聚丙烯网片周围，只有在丝线交错点处能看到大的成纤维细胞群。因此，可以得出结论，两种网片都能刺激成纤维细胞良好地附着和增殖，但方式和数量非常不同；外科医生将根据具体的手术目的选择合适的网片。
