Pierce Lisa M, Rao Arundhati, Baumann Shannon S, Glassberg Jocylen E, Kuehl Thomas J, Muir Tristi W
Department of Obstetrics and Gynecology, Scott & White Memorial Hospital and Clinic, Texas A&M University Health Science Center College of Medicine, Temple, TX, USA.
Am J Obstet Gynecol. 2009 May;200(5):546.e1-8. doi: 10.1016/j.ajog.2008.12.040. Epub 2009 Mar 16.
We sought to evaluate the effects of graft type, site of implantation, and ovariectomy on the long-term histologic response to graft materials used in pelvic reconstructive surgery.
In all, 45 rabbits underwent ovariectomy or sham laparotomy and were implanted with polypropylene (PP) mesh (n = 23) or cross-linked porcine dermis (PS) (n = 22) in the vagina and abdomen. Grafts were harvested 9 months later and were processed for histology to evaluate the host inflammatory response and degree of tissue incorporation within the grafts.
Polypropylene induced a milder (P < .007), more uniform response than PS, whereas PS elicited a more variable response and degraded by 9 months. Vaginal grafts had higher scores for inflammation (P = .005) and neovascularization (P < .001), and had lower scores for fibroblastic proliferation (P < .001) than abdominal grafts. Ovariectomy had no effect (P > .05).
Synthetic and biologic grafts evoke different foreign body responses, which may have implications for surgical outcomes in women.
我们试图评估移植物类型、植入部位和卵巢切除术对盆腔重建手术中使用的移植物材料的长期组织学反应的影响。
总共45只兔子接受了卵巢切除术或假剖腹手术,并在阴道和腹部植入聚丙烯(PP)网片(n = 23)或交联猪真皮(PS)(n = 22)。9个月后取出移植物,进行组织学处理,以评估宿主炎症反应和移植物内组织整合程度。
聚丙烯引起的反应比PS更轻微(P <.007)、更均匀,而PS引起的反应更具变异性,并且在9个月时发生降解。与腹部移植物相比,阴道移植物的炎症评分(P =.005)和新生血管形成评分更高(P <.001),而纤维母细胞增殖评分更低(P <.001)。卵巢切除术无影响(P >.05)。
合成移植物和生物移植物引发不同的异物反应,这可能对女性的手术结果产生影响。