Judge Timothy W, Parker David M, Dinsmore Robert C
Department of Surgery, Eisenhower Army Medical Center, Ft Gordon, GA 30905, USA.
J Am Coll Surg. 2007 Feb;204(2):276-81. doi: 10.1016/j.jamcollsurg.2006.11.003. Epub 2006 Dec 20.
This study compared Parietex composite mesh (PCM) with Sepramesh (SM) in terms of strength of tissue incorporation, adhesion formation, and mesh shrinkage, using an animal model.
A two-phase, prospective, randomized study using 44 New Zealand white rabbits. Each animal underwent creation of a standardized ventral hernia defect, followed by repair using either SM or PCM. Half of each group was sacrificed and examined at 1 month, and the remainder at 5 months. Outcomes measurements were strength of incorporation (SOI), type and area of adhesions (AA), and mesh shrinkage.
SOI for PCM was much greater than for SM, both at 1 month (60.8 N versus 42.6 N) and 5 months (70.9 N versus 31.5 N). The incidence of bowel adhesions was lower with PCM than SM, both at 1 month (1 versus 6) and at 5 months (0 versus 4). At 5 months, PCM demonstrated lower AA, both as a percentage of the mesh (5.6% versus 12.8%) and in terms of absolute area involved (321 mm(2) versus 840 mm(2)). PCM underwent considerably more shrinkage than SM, at both 1 month (38.2% versus 18.1%) and 5 months (17.4% versus 6.1%).
PCM demonstrated a substantially stronger SOI, which improved over time, and SOI of SM decreased. PCM was also superior in terms of adhesion prevention, but underwent considerably more shrinkage in this experimental model.
本研究使用动物模型,在组织植入强度、粘连形成和网片收缩方面,对帕里泰克斯复合补片(PCM)和赛普拉斯补片(SM)进行了比较。
一项两阶段、前瞻性、随机研究,使用44只新西兰白兔。每只动物都接受了标准化腹疝缺损的创建,然后使用SM或PCM进行修复。每组动物的一半在1个月时处死并进行检查,其余的在5个月时处死并检查。结果测量指标为植入强度(SOI)、粘连类型和面积(AA)以及网片收缩情况。
PCM的SOI在1个月时(60.8 N对42.6 N)和5个月时(70.9 N对31.5 N)均远高于SM。PCM组肠粘连的发生率在1个月时(1例对6例)和5个月时(0例对4例)均低于SM组。在5个月时,PCM的AA无论是占网片的百分比(5.6%对12.8%)还是绝对受累面积(321 mm²对840 mm²)都更低。PCM在1个月时(38.2%对18.1%)和5个月时(17.4%对6.1%)的收缩程度均比SM大得多)。
PCM表现出明显更强的SOI,且随时间推移有所改善,而SM的SOI则下降。PCM在预防粘连方面也更具优势,但在该实验模型中收缩程度要大得多。