Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8109, St. Louis, MO, 63110, USA.
Surg Endosc. 2012 Feb;26(2):566-75. doi: 10.1007/s00464-011-1899-3. Epub 2011 Sep 5.
The objective of this review was to provide an overview of the components that comprise each of the eight barrier mesh prostheses commonly utilized for LVHR and to review the current literature related to the characteristics and effectiveness of these materials to guide the general surgeon in selecting the most appropriate material for LVHR.
Composite prostheses with permanent barriers (Bard™ Composix™ E/X, Bard™ Composix™ L/P, and DUALMESH(®) Biomaterial) were compared to composite prostheses with absorbable barriers (C-QUR™ Mesh, PROCEED™ Surgical Mesh, Bard™ Sepramesh™ IP Composite, Parietex™ Composite, and PHYSIOMESH™) using scanning electron microscopy and a review of the current preclinical and clinical literature.
Clinical studies and preclinical animal models have attempted to determine the adhesion characteristics and effectiveness of barrier mesh prostheses available for ventral hernia repair applications. However, it is difficult to make any definitive statements about the adhesion characteristics and effectiveness of these materials because all meshes were not included in all studies and likewise not compared under identical conditions. Overall, Parietex™ Composite and DUALMESH(®) Biomaterial were cited most frequently for improvement of adhesion characteristics, followed closely by Bard™ Sepramesh™ IP Composite and C-QUR™ Mesh. Bard™ Composix™, PROCEED™ Surgical Mesh, and uncoated polypropylene were cited most frequently as having the most tenacious and extensive adhesions.
Differences observed between the various barrier prostheses are likely attributable to the chemical composition of the barrier or the conditions required for resorption and metabolism of the barrier components. It is likely that the components of these barriers incite a wide range of inflammatory responses resulting in the range of adhesion coverage and tenacity observed in the preclinical and clinical studies reviewed. Clinical trials are needed to more appropriately define the clinical effectiveness of these barriers.
本综述的目的是概述常用于左心室重建术（LVHR）的八种屏障网片假体的各个组成部分，并回顾与这些材料的特性和有效性相关的现有文献，以指导普通外科医生选择最适合 LVHR 的材料。
使用扫描电子显微镜对具有永久性屏障的复合假体（Bard™ Composix™ E/X、Bard™ Composix™ L/P 和 DUALMESH(®) Biomaterial）与具有可吸收屏障的复合假体（C-QUR™ Mesh、PROCEED™ Surgical Mesh、Bard™ Sepramesh™ IP Composite、Parietex™ Composite 和 PHYSIOMESH™）进行了比较，并回顾了当前的临床前和临床文献。
临床研究和临床前动物模型试图确定用于腹疝修补应用的屏障网片假体的黏附特性和有效性。然而，由于并非所有网片都包含在所有研究中，并且并非在相同条件下进行比较，因此很难对这些材料的黏附特性和有效性做出任何明确的陈述。总体而言，Parietex™ Composite 和 DUALMESH(®) Biomaterial 被引用最多，用于改善黏附特性，其次是 Bard™ Sepramesh™ IP Composite 和 C-QUR™ Mesh。Bard™ Composix™、PROCEED™ Surgical Mesh 和未涂层的聚丙烯被引用最多，因为它们具有最顽强和广泛的黏附性。
各种屏障假体之间观察到的差异可能归因于屏障的化学成分或屏障成分吸收和代谢所需的条件。这些屏障的组成部分很可能引起广泛的炎症反应，导致临床前和临床研究中观察到的黏附覆盖范围和强度的差异。需要进行临床试验以更恰当地定义这些屏障的临床有效性。
