Cobb William S, Burns Justin M, Peindl Richard D, Carbonell Alfredo M, Matthews Brent D, Kercher Kent W, Heniford B Todd
Department of General Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
J Surg Res. 2006 Nov;136(1):1-7. doi: 10.1016/j.jss.2006.05.022. Epub 2006 Sep 22.
The purpose of this study was to assess the burst strength and stiffness of heavy weight (HW), mid-weight (MW), and light weight (LW) polypropylene mesh pre-implantation and 5 months post-implantation in a porcine ventral hernia model.
HW (95 g/cm2), MW (45 g/cm2), and LW (28 g/cm2) polypropylene were tested as dry samples (n = 8/mesh) before implantation using a stamp strain machine. Three weeks after creating four hernia defects in each mini-pig (n = 18), the polypropylene meshes (8 x 10 cm; 24/mesh type) were implanted in the preperitoneal space, ensuring 2 cm overlap circumferentially. At 5 months, the mesh was harvested en bloc with the abdominal wall. Testing of burst strength and stiffness was repeated on the ex vivo specimens.
After implantation in the pig for 5 months, the mean burst strength and stiffness of HW and MW meshes remains the same. LW mesh with an absorbable monofilament in its weave has significant reductions in mean burst strength (P = 0.01) and mean stiffness (P < 0.0001). The burst strength for all meshes tested was much higher than measured for the abdominal wall fascia alone. The degree of shrinkage of the various weight meshes did not differ.
A reduction in mean burst strength and stiffness occurs after 5 months implantation of LW polypropylene mesh with an absorbable monofilament. All meshes exhibited burst strengths that were much greater than the burst strength of the abdominal wall fascia alone. After tissue incorporation, the LW polypropylene mesh maintains mean burst strength comparable to MW polypropylene mesh, while becoming less stiff than HW mesh. Long-term, this may contribute to more physiological abdominal wall compliance after LW polypropylene mesh implantation.
本研究的目的是评估在猪腹疝模型中,重磅(HW)、中磅(MW)和轻磅(LW)聚丙烯补片植入前及植入后5个月的破裂强度和刚度。
使用冲压应变机,将HW(95 g/cm²)、MW(45 g/cm²)和LW(28 g/cm²)聚丙烯作为干燥样本(每种补片n = 8)在植入前进行测试。在每只小型猪(n = 18)制造4个疝缺损3周后,将聚丙烯补片(8×10 cm;每种补片类型24片)植入腹膜前间隙,确保周向重叠2 cm。5个月时,将补片与腹壁整块切除。对离体标本重复进行破裂强度和刚度测试。
在猪体内植入5个月后,HW和MW补片的平均破裂强度和刚度保持不变。编织中有可吸收单丝的LW补片,其平均破裂强度(P = 0.01)和平均刚度(P < 0.0001)显著降低。所有测试补片的破裂强度均远高于单独测量的腹壁筋膜。不同重量补片的收缩程度无差异。
植入含可吸收单丝的LW聚丙烯补片5个月后,平均破裂强度和刚度降低。所有补片的破裂强度均远大于单独腹壁筋膜的破裂强度。组织整合后,LW聚丙烯补片的平均破裂强度与MW聚丙烯补片相当,同时刚度低于HW补片。从长期来看,这可能有助于LW聚丙烯补片植入后腹壁顺应性更接近生理状态。