Pós-Graduação de Gastroenterologia Cirúrgica, Universidade Federal de São Paulo, Rua Napoleão de Barros, 610-Vila Clementino, São Paulo, SP, CEP 04024-002, Brazil.
Hernia. 2010 Jun;14(3):299-304. doi: 10.1007/s10029-009-0621-z. Epub 2010 Jan 14.
Incisional hernia occurs in approximately 11% of all laparotomies. Changes in collagen have been closely implicated in its pathogenesis. The high recurrence rate (45-54%) after primary suture has stimulated the development of meshes. Currently, meshes are the biomaterials implant group most used in medicine. This study aims to compare the serum and tissue inflammatory responses and collagen deposition caused by meshes made of polypropylene, polypropylene + polyglactin and polypropylene + titanium.
Thirty Wistar rats were divided into three groups. In group I, a high-density polypropylene mesh was positioned on the abdominal wall. In groups II and III, low-density meshes were used in associations with polyglactin and titanium, respectively. Immediately before the operation and on the first, third and fortieth postoperative days, pro-inflammatory cytokines were assayed. On the 40th postoperative day, the region of the inserted prosthesis was biopsied. The tissue inflammatory reaction was evaluated using a scale for objective scoring. For collagen, picrosirius was used with data reading using the Image Tool computer software.
Cytokines: there were no statistically significant differences between the groups.
on the 40th postoperative day in group I, there were fewer inflammatory tissue response and greater collagen deposition (P < 0.01). In group II, there were greater inflammatory tissue response and less collagen deposition (P < 0.01). Group III presented intermediate values between groups I and II.
There were no significant differences in cytokine levels between the groups in the present study. In the animals with the polypropylene + polyglactin mesh implant there was the most intense inflammatory process with lower tissue maturation and collagen deposition on the 40th postoperative day. The polypropylene mesh presented a less severe late inflammatory process, with greater tissue maturation and collagen deposition. The polypropylene + titanium mesh presented intermediate values between the others.
切口疝发生在约 11%的剖腹手术中。胶原蛋白的变化与该病的发病机制密切相关。初次缝合后的高复发率（45-54%）刺激了网片的发展。目前，网片是生物材料植入物中在医学中应用最广泛的一组材料。本研究旨在比较由聚丙烯、聚丙烯+聚乳酸和聚丙烯+钛制成的网片引起的血清和组织炎症反应和胶原蛋白沉积。
将 30 只 Wistar 大鼠分为三组。在第 I 组中，在腹壁上放置高密度聚丙烯网片。在第 II 组和第 III 组中，分别使用低密度网片与聚乳酸和钛结合。在手术前和术后第 1、3、40 天测定促炎细胞因子。在术后第 40 天，对插入假体的区域进行活检。用组织炎症反应客观评分量表评估组织炎症反应。对于胶原蛋白，使用苦味酸进行染色，并使用 Image Tool 计算机软件进行数据读取。
细胞因子：各组间无统计学差异。
术后第 40 天，第 I 组炎症组织反应较轻，胶原蛋白沉积较多（P < 0.01）。第 II 组炎症组织反应较强，胶原蛋白沉积较少（P < 0.01）。第 III 组在第 I 组和第 II 组之间呈现中间值。
本研究各组细胞因子水平无显著差异。在植入聚丙烯+聚乳酸网片的动物中，第 40 天出现最强烈的炎症反应，组织成熟度较低，胶原蛋白沉积较少。聚丙烯网片表现出较轻的晚期炎症反应，组织成熟度较高，胶原蛋白沉积较多。聚丙烯+钛网片在其他两者之间呈现中间值。
