Vaz Márcia, Krebs Rodrigo Ketzer, Trindade Eduardo Neubarth, Trindade Manoel Roberto Maciel
Department of Surgery, Division of Gastrointestinal Surgery, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Acta Cir Bras. 2009 Jan-Feb;24(1):19-25. doi: 10.1590/s0102-86502009000100005.
This study assessed the collagen deposition and correlated it with local inflammatory responses to evaluate the length of time required for fibroplasia when polypropylene meshes are used to repair incisional abdominal wall hernias in rats.
Thirty-six male Wistar rats underwent longitudinal resection of a peritoneal and musculoaponeurotic tissue segment (3x2 cm) of the abdominal wall followed by defect reconstruction with polypropylene mesh bridging over aponeurosis. The animals were divided into 6 groups according to the time points for the analysis of fibroplasia: 1, 2, 3, 7, 21 and 30 days post-implantation. Animals were sacrificed at each time point, and the site where the polypropylene mesh was implanted was evaluated histologically to assess inflammatory response and percentage of collagen using computer-assisted videomorphometry.
Total collagen was found at the mesh site on the 3rd day post-implantation, and increased progressively on all subsequent days up to the 21st day, when it reached its highest percentage (p<0.001). Type III collagen increased progressively from the 3rd to the 21st days, when it reached its highest percentage (p<0.001); on the 30th day, it decreased significantly (p>0.001). Type I collagen was first found between the 7th and 21st days; it reached its highest percentage on the 21st day and then remained stable until the 30th day. The type I to type III collagen ratio increased significantly and progressively up to the 30th day (p<0.001). Neutrophils were found at the mesh site from the 1st to the 21st day post-implantation. Macrophages, giant cells and lymphocytes were seen on the 2nd day. Thirty days after mesh implantation, neutrophils disappeared, but the percentages of macrophages, giant cells and lymphocytes remained stable (p<0.001).
This study showed that total collagen was first seen on the 3rd day post-implantation, with a higher percentage of type I collagen at the last observational time point. The prolonged healing inflammatory response and the persistence of chronic inflammation surrounding to the mesh did not affect the length of time required for fibroplasia.
本研究评估了胶原蛋白沉积情况，并将其与局部炎症反应相关联，以评估在大鼠腹壁切口疝修补术中使用聚丙烯网片时纤维组织形成所需的时间。
36只雄性Wistar大鼠接受腹壁腹膜和肌筋膜组织段（3×2 cm）的纵向切除，然后用聚丙烯网片在腱膜上搭桥进行缺损修复。根据纤维组织形成分析的时间点将动物分为6组：植入后1、2、3、7、21和30天。在每个时间点处死动物，对植入聚丙烯网片的部位进行组织学评估，使用计算机辅助视频形态测量法评估炎症反应和胶原蛋白百分比。
植入后第3天在网片部位发现总胶原蛋白，随后直至第21天其百分比逐渐增加，在第21天达到最高（p<0.001）。III型胶原蛋白从第3天到第21天逐渐增加，在第21天达到最高百分比（p<0.001）；在第30天，其显著下降（p>0.001）。I型胶原蛋白在第7天至第21天首次发现；在第21天达到最高百分比，然后直至第30天保持稳定。I型与III型胶原蛋白的比例在第30天之前显著且逐渐增加（p<0.001）。植入后第1天至第21天在网片部位发现中性粒细胞。在第2天可见巨噬细胞、巨细胞和淋巴细胞。网片植入30天后，中性粒细胞消失，但巨噬细胞、巨细胞和淋巴细胞的百分比保持稳定（p<0.001）。
本研究表明，植入后第3天首次发现总胶原蛋白，在最后观察时间点I型胶原蛋白百分比更高。延长的愈合炎症反应以及网片周围慢性炎症的持续存在并未影响纤维组织形成所需的时间。
