Chobola M, Voboril Z, Hadzi Nikolov D
Chirurgická klinika FN a LF UK, Hradec Králové.
Rozhl Chir. 2005 Mar;84(3):128-33.
Polyester and polypropylene are currently the most frequently materials for repair of abdominal wall hernias. Most of the mesh materials used intraperitoneally in repair of hernias lead to considerable adhesion formation, as well as the resultant bowel obstruction and intestinal fistula formation. Some newer composite products can reduce risk of adhesion formation. The aim of this experimental study is testing properties of patch, composite structure, characterised by the association of a non-woven textile structure made from polyester multifilaments, and a fine coat of polyurethane on one side, placed intraperitoneally in rat.
The experiment was carried out with 21 laboratory rats. Laboratory animals were divided into 3 groups - 7 animals in a group. In the first group the check-up laparotomy was realized the 7th day, in the second group the 14th day and in the third group the 28th day after the intraperitoneal implantation of a composite mesh. All animals were sacrificed and adhesion scoring and histological evaluation of tissue specimens with implanted mesh were done.
A macroporous polyester mesh component supported an early and huge fibrous proliferation with a good adhesion onto the abdomen wall. On the other hand, a microporous polyurethane layer led to the creation of a fibrous pocket. During the check-up laparotomy, the larger adhesion of omentum to the fibrous layer, covering the polyurethane side of implanted mesh, were located in most laboratory rats - in all the groups.
We can presume that the protective polyurethane layer does not eliminate risk of adhesion formation in rat.
聚酯和聚丙烯是目前修复腹壁疝最常用的材料。大多数用于疝修补术的腹腔内网状材料会导致大量粘连形成，以及由此产生的肠梗阻和肠瘘形成。一些新型复合产品可降低粘连形成的风险。本实验研究的目的是测试一种贴片复合结构的特性，该结构由聚酯复丝制成的非织造织物结构与一侧的精细聚氨酯涂层相结合，将其腹腔内植入大鼠体内。
实验用21只实验大鼠进行。实验动物分为3组，每组7只。第一组在复合网片腹腔内植入后第7天进行检查性剖腹手术，第二组在第14天进行，第三组在第28天进行。所有动物均处死后，对植入网片的组织标本进行粘连评分和组织学评估。
大孔聚酯网片成分支持早期大量纤维增生，并与腹壁有良好粘连。另一方面，微孔聚氨酯层导致形成纤维囊。在检查性剖腹手术期间，大多数实验大鼠（所有组）的大网膜与覆盖植入网片聚氨酯侧的纤维层粘连较大。
我们可以推测，保护性聚氨酯层并不能消除大鼠粘连形成的风险。
