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对粘连形成的抵抗作用:置于腹腔内的经处理和未处理的网片产品的比较研究

Resistance to adhesion formation: a comparative study of treated and untreated mesh products placed in the abdominal cavity.

作者信息

Gonzalez R, Rodeheaver G T, Moody D L, Foresman P A, Ramshaw B J

机构信息

Hernia Institute, Endosurgery Unit, Surgery Department H-124 B, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322, USA.

出版信息

Hernia. 2004 Aug;8(3):213-9. doi: 10.1007/s10029-004-0213-x. Epub 2004 Mar 18.

Abstract

BACKGROUND

New materials have been devised to prevent postoperative adhesions when placing a prosthesis in contact with abdominal contents.

METHODS

Eighty rats underwent laparotomy and denudation of the serosa of the cecum and peritoneal covering of the abdominal wall. Five treated mesh products (Parietex Composite, Parietene Composite, Bard Composix E/X, Sepramesh, and Gore-Tex Dual Mesh) and one untreated mesh product (untreated Parietene) were randomly placed between the cecum and abdominal wall. A group without mesh was used as control. The animals were sacrificed at 21 days following surgery and analyzed for the presence of adhesions.

RESULTS

The incidence of adhesion formation, mean adhesion area, maximum adhesion length, and strength of adhesion separation were similar between Parietex Composite, Parietene Composite, and Bard Composix E/X, and they were significantly less than with Sepramesh, untreated Parietene, and the control group. Gore-Tex Dual Mesh resulted in less adhesions, adhesion area, mean strength of separation, and work of separation than the untreated Parietene group and the control group. Sepramesh resulted in less strength and work of separation compared to the control group.

CONCLUSIONS

The incidence of adhesions and work and strength of adhesion separation are reduced when using a treated mesh, compared to the untreated mesh and the control group without mesh. Parietex Composite, Parietene Composite, Bard Composix E/X, and Gore-Tex Dual Mesh were superior to Sepramesh, untreated Parietene, and the control group in the prevention of adhesion formation.

摘要

背景

已设计出新型材料,用于在假体与腹腔内容物接触时预防术后粘连。

方法

80只大鼠接受剖腹手术,并对盲肠浆膜和腹壁腹膜覆盖层进行剥脱。将五种经处理的网片产品(百达复复合补片、帕利坦复合补片、巴德Composix E/X补片、Sepramesh补片和戈尔泰斯双层网片)和一种未经处理的网片产品(未处理的帕利坦补片)随机置于盲肠和腹壁之间。将一组不使用网片的大鼠作为对照。术后21天处死动物,分析粘连情况。

结果

百达复复合补片、帕利坦复合补片和巴德Composix E/X补片之间的粘连形成发生率、平均粘连面积、最大粘连长度和粘连分离强度相似,且显著低于Sepramesh补片、未处理的帕利坦补片和对照组。戈尔泰斯双层网片产生的粘连、粘连面积、平均分离强度和分离功均少于未处理的帕利坦补片组和对照组。与对照组相比,Sepramesh补片产生的分离强度和分离功较小。

结论

与未处理的网片和无网片的对照组相比,使用经处理的网片时粘连发生率以及粘连分离的功和强度降低。在预防粘连形成方面,百达复复合补片、帕利坦复合补片、巴德Composix E/X补片和戈尔泰斯双层网片优于Sepramesh补片、未处理的帕利坦补片和对照组。

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