Esfandiari Adeleh, Nowrouzian Iradj
Department of Otolaryngology, Biological Research, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.
J Am Assoc Lab Anim Sci. 2006 Jan;45(1):48-51.
Incisional hernias due to trauma, infection, or tumor are a common abdominal wall defect. Repair of these defects when autogenous tissue is insufficient or inadequate often results in abdominal tissue adhesion. These adhesions often lead to complications such as intestinal obstruction and enterocutaneous fistula. Previous reports have shown that application of prosthetic materials, such as polypropylene mesh and anionic polysaccharides, has been effective in reducing the amount of tissue adhesion. However, some tissue adhesion still occurs with application of these materials when previously described methodologies are used. We evaluated the efficacy of a novel surgical approach that combines the application of Sepramesh, a coated polypropylene mesh, and Seprafilm, composed of anionic polysaccharides (both products from Genzyme, Cambridge, MA), in the repair of abdominal wall hernias. We report that combined application of these 2 materials in a "sandwich technique", by placing the peritoneum between the Seprafilm and Sepramesh, further reduces (and in some instances prevents) tissue adhesion after abdominal wall defects in mice. Moreover, our combined treatment markedly decreased tissue inflammation after hernia repair.
由创伤、感染或肿瘤引起的切口疝是一种常见的腹壁缺损。当自体组织不足或不充分时，修复这些缺损往往会导致腹部组织粘连。这些粘连常常导致肠梗阻和肠皮肤瘘等并发症。先前的报告表明，应用诸如聚丙烯网片和阴离子多糖等假体材料在减少组织粘连量方面是有效的。然而，当使用先前描述的方法应用这些材料时，仍会发生一些组织粘连。我们评估了一种新型手术方法的疗效，该方法结合应用Sepramesh（一种涂层聚丙烯网片）和Seprafilm（由阴离子多糖组成，这两种产品均来自马萨诸塞州剑桥市的Genzyme公司）来修复腹壁疝。我们报告，通过将腹膜置于Seprafilm和Sepramesh之间，以“三明治技术”联合应用这两种材料，可进一步减少（在某些情况下可防止）小鼠腹壁缺损后的组织粘连。此外，我们的联合治疗显著降低了疝修补术后的组织炎症。
