Department of General Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA.
Aesthetic Plast Surg. 2010 Jun;34(3):290-6. doi: 10.1007/s00266-009-9449-2. Epub 2009 Dec 5.
Surgisis and AlloDerm, two biosynthetic materials, have been previously used with success in abdominal wall repairs in the setting of contaminated fields. Historically, Vicryl Woven Mesh, a synthetic material, has also been used in such settings as a temporary bridge for abdominal wall reconstruction. This study compares Surgisis and AlloDerm with Vicryl Woven Mesh with respect to tensile strength, collagen remodeling, and neovascularization using a rat hernia model.
A prospective randomized trial of 54 Sprague-Dawley rats were assigned to the Surgisis, AlloDerm, or Vicryl Woven Mesh group with baseline, 30-day, and 60-day end points. A 1.5-cm x 5.0-cm defect was created in the right abdominis rectus muscle and repaired with an underlay bridge graft using the different treatment materials. Tensile strength was measured using an Instron tensiometer. Histologic specimens were evaluated for neovascularization, collagen deposition, and collagen organization at the 30- and 60-day time points.
Surgisis had significantly greater tensile strength compared to Vicryl Woven Mesh at the baseline time point (0.142 vs. 0.091 MPa, p < 0.05). There were no differences between groups tensile strength at 30 or 60 days postoperatively. The Vicryl Woven Mesh and AlloDerm groups showed increases in tensile strength at 30 days postoperatively versus baseline (p < 0.05). Vicryl Woven Mesh, Surgisis, and AlloDerm all showed increases in tensile strength at 60 days postoperatively compared to 30 days postoperatively and at baseline (p < 0.05). Surgisis and AlloDerm had significantly greater (p < 0.05) amounts of collagen deposition and organization at 30 and 60 days compared to Vicryl Woven Mesh. There was no significant difference between AlloDerm and Surgisis with respect to collagen deposition and organization. Surgisis and AlloDerm showed a significantly greater amount (p < 0.05) of neovascularization than Vicryl Woven Mesh at both time points. In addition, Surgisis had a significantly greater amount (p < 0.05) of neovascularization than AlloDerm at both 30 and 60 days.
Surgisis has increased baseline tensile strength compared to Vicryl Woven Mesh. Tensile strength in Vicryl Woven Mesh is equal to biosynthetic grafts after tissue incorporation. Biosynthetic grafts showed superior collagen deposition and organization. Surgisis mesh showed increased neovascularization over both AlloDerm and Vicryl Woven Mesh.
Surgisis 和 AlloDerm 这两种生物合成材料在污染区域的腹壁修复中已成功应用。历史上，Vicryl 编织网（一种合成材料）也被用作腹壁重建的临时桥接材料。本研究通过大鼠疝模型比较了 Surgisis、AlloDerm 与 Vicryl 编织网在拉伸强度、胶原重塑和新生血管形成方面的差异。
54 只 Sprague-Dawley 大鼠前瞻性随机分组，分别接受 Surgisis、AlloDerm 或 Vicryl 编织网治疗，基线、30 天和 60 天为时间点。在右侧腹直肌中创建 1.5cm×5.0cm 的缺损，使用不同的治疗材料进行下置桥接移植。采用 Instron 拉力试验机测量拉伸强度。在 30 天和 60 天时间点评估组织学标本的新生血管形成、胶原沉积和胶原组织。
Surgisis 在基线时的拉伸强度显著大于 Vicryl 编织网（0.142 比 0.091MPa，p<0.05）。术后 30 天和 60 天，各组之间的拉伸强度没有差异。Vicryl 编织网和 AlloDerm 组在术后 30 天的拉伸强度均高于基线（p<0.05）。与术后 30 天和基线相比，Vicryl 编织网、Surgisis 和 AlloDerm 在术后 60 天的拉伸强度均增加（p<0.05）。Surgisis 和 AlloDerm 在 30 天和 60 天的胶原沉积和组织方面显著高于 Vicryl 编织网（p<0.05）。AlloDerm 和 Surgisis 之间的胶原沉积和组织无显著差异。Surgisis 和 AlloDerm 在两个时间点的新生血管形成均显著多于 Vicryl 编织网（p<0.05）。此外，Surgisis 在 30 天和 60 天的新生血管形成均显著多于 AlloDerm（p<0.05）。
Surgisis 的拉伸强度基线值高于 Vicryl 编织网。Vicryl 编织网在组织整合后与生物合成移植物的拉伸强度相当。生物合成移植物显示出优越的胶原沉积和组织。Surgisis 网的新生血管形成明显多于 AlloDerm 和 Vicryl 编织网。
