Centre for Surgical Technologies, Catholic University Leuven, University Hospitals Gasthuisberg, Leuven, Belgium.
Neurourol Urodyn. 2010 Mar;29(3):488-93. doi: 10.1002/nau.20755.
Graft materials used for pelvic floor reinforcement should still be considered as investigational and, therefore, evaluated experimentally and within clinical trials. The present report describes our biomechanical findings in rats implanted with selected novel implant materials, which in recent years have been suggested as alternatives to plain polypropylene (PP) meshes.
Full thickness abdominal wall defects were primarily repaired by the implant of interest. Experiments involved eight different implant materials: two partly degradable synthetic implants, that is, a hybrid of polyglactin 910 with PP (Vypro II) and collagen coated PP (Pelvitex); two non-cross linked (Surgisis, InteXēn LP) and two cross-linked materials (Pelvicol, Pelvisoft) and two porous modifications of InteXēn LP and Pelvicol implants. At different time points (7, 14, 30, and 90 days), the implants and surrounding host tissue (explant) were harvested and tensiometry was performed. Tensile strength and location of breakage were recorded.
In general resorbable non-cross linked collagen matrices and porous materials were weaker after 90 days; similar behavior was seen for implant materials alone and their construction with the surrounding native tissue. Both non-porous and porous modification of InteXēn LP appeared at 90 days as a very thin layer of collagen that was two-thirds, respectively one-third of the initial thickness.
In experimental conditions, sufficient strength was obtained only after 3 months, and PP containing constructs appeared as the strongest though reconstruction with Pelvicol showed comparable outcomes. Lower values for strength of non-cross linked and porous collagen materials are questioning their efficacy for pelvic floor reconstruction.
用于盆底加强的移植物材料仍应被视为研究性的,因此应通过实验和临床试验进行评估。本报告描述了我们在植入选定新型植入物材料的大鼠中的生物力学发现,这些材料近年来已被提议作为普通聚丙烯(PP)网片的替代品。
通过植入感兴趣的植入物来主要修复全层腹壁缺损。实验涉及 8 种不同的植入物材料:两种部分可降解合成植入物,即聚丙交酯 910 与 PP 的混合物(Vypro II)和涂胶原的 PP(Pelvitex);两种非交联(Surgisis、InteXēn LP)和两种交联材料(Pelvicol、Pelvisoft)以及 InteXēn LP 和 Pelvicol 植入物的两种多孔改性材料。在不同的时间点(7、14、30 和 90 天),收获植入物和周围宿主组织(移植物)并进行张力测定。记录拉伸强度和断裂位置。
一般来说,可吸收的非交联胶原基质和多孔材料在 90 天后强度较弱;植入物材料本身及其与周围天然组织的构建也表现出类似的行为。InteXēn LP 的非多孔和多孔改性在 90 天时均表现为胶原的非常薄的层,分别为初始厚度的三分之二和三分之一。
在实验条件下,仅在 3 个月后才能获得足够的强度,并且含有 PP 的构建物表现出最强的强度,尽管使用 Pelvicol 进行重建的结果相当。非交联和多孔胶原材料强度较低,对其用于盆底重建的疗效提出了质疑。