Rudolphy V J, Tukkie R, Klopper P J
Department of Experimental Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Ann Thorac Surg. 1991 Oct;52(4):821-5. doi: 10.1016/0003-4975(91)91218-k.
Chest wall defects resulting from oncological operations often require prosthetic repair. The objectives of prosthetic repair are to provide a cosmetically acceptable substitute, prevent paradoxical chest wall movement, and protect vital organs. Of the many materials that have been used in these repairs, none have proved to be ideal. The aim of our study was to investigate the application of a biodegradable material--processed sheep dermal collagen--as a chest wall prosthesis. A full-thickness chest wall defect of 10 x 10 cm was created in 12 dogs; 10 had repair with a processed sheep dermal collagen prosthesis and 2, the controls, with polypropylene mesh. In this study, the biomaterial fulfilled its function as a chest wall prosthesis at 24 weeks' follow-up. No respiratory problems were seen, the chest wall remained stable with minimal and decreasing respiratory paradoxical movement, and the processed sheep dermal collagen slowly degraded and was replaced by the host collagen. Processed sheep dermal collagen offers long-term advantages because it is degradable. Late complications from a nonabsorbable prosthesis, ie, infection or disintegration of the material possibly causing extrusion or fistula formation, are avoided.
肿瘤手术导致的胸壁缺损通常需要进行假体修复。假体修复的目的是提供一个在美学上可接受的替代物，防止胸壁反常运动，并保护重要器官。在这些修复中使用过的众多材料中，没有一种被证明是理想的。我们研究的目的是探讨一种可生物降解材料——经处理的绵羊真皮胶原蛋白——作为胸壁假体的应用。在12只犬身上制造了一个10×10厘米的全层胸壁缺损；10只使用经处理的绵羊真皮胶原蛋白假体进行修复，2只作为对照，使用聚丙烯网片。在本研究中，这种生物材料在24周的随访中发挥了胸壁假体的功能。未观察到呼吸问题，胸壁保持稳定，呼吸反常运动轻微且逐渐减少，经处理的绵羊真皮胶原蛋白缓慢降解并被宿主胶原蛋白替代。经处理的绵羊真皮胶原蛋白具有长期优势，因为它是可降解的。避免了不可吸收假体的晚期并发症，即材料的感染或崩解可能导致的挤压或瘘管形成。
