Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, D-55099 Mainz, Germany.
Med Eng Phys. 2012 Sep;34(7):806-16. doi: 10.1016/j.medengphy.2011.09.022. Epub 2011 Oct 10.
An ideal prosthetic mesh for incisional hernia repair should mimic the anisotropic compliance of the abdominal wall, and at lower loads should exhibit higher distensibility without impairment of safety at higher loads. This study evaluated the biomechanical properties of six meshes in a rabbit model.
New Zealand white rabbits were used for this study. Two meshes of the same brand (Ethicon Physiomesh™, Bard Composix(®) L/P, Gore Dualmesh(®), Bard Sepramesh(®), Ethicon Proceed(®) or Parietex™ Composite) were implanted into each animal for assessment of intra-abdominal hernia repair, with a total of ten meshes per group. Twelve weeks after implantation, the abdominal walls with ingrown meshes were harvested and examined biomechanically with a plunger test. The mesh-tissue compliance was evaluated by the forces exerted at given displacements and also described through a simple mathematical approximation. Abdominal wall samples were collected for histopathology, cell turnover and morphometry.
No mesh-related complications were seen. The adhesion score was significantly higher in Bard Composix(®) L/P and Ethicon Proceed(®) meshes. Significant shrinkage was seen in Gore Dualmesh(®) and Parietex™ Composite meshes. Physiomesh™ exhibited the highest compliance during plunger testing, characterized by lower, more physiological reaction forces against tissue displacement than the competitor meshes. In contrast, the safety modulus was comparable in all groups. Histology showed less collagen and less foreign body reaction in the Physiomesh™ samples contributing to patient's comfort.
In terms of safety, this study showed no superiority of any single mesh. The comfort modulus however differed, being lowest in the newly developed Physiomesh™.
用于切口疝修补的理想补片应模拟腹壁的各向异性顺应性，并且在较低的负载下应表现出更高的可扩展性，而在较高的负载下不会损害安全性。本研究在兔模型中评估了六种补片的生物力学特性。
本研究使用新西兰白兔。每个动物植入相同品牌的两种补片（Ethicon Physiomesh™、Bard Composix® L/P、Gore Dualmesh®、Bard Sepramesh®、Ethicon Proceed® 或 Parietex™ Composite）用于评估腹内疝修补，每组各有十个补片。植入后 12 周，取出植入有补片的腹壁进行生物力学测试，使用柱塞试验。通过在给定位移下施加的力评估补片-组织顺应性，并通过简单的数学近似来描述。收集腹壁标本进行组织病理学、细胞更新和形态学分析。
未观察到与补片相关的并发症。Bard Composix® L/P 和 Ethicon Proceed® 补片的粘连评分显著更高。Gore Dualmesh® 和 Parietex™ Composite 补片明显收缩。在柱塞试验中，Physiomesh™ 表现出最高的顺应性，其对组织位移的反应力较低，更接近生理反应，与竞争补片相比。相比之下，所有组的安全系数相当。组织学显示 Physiomesh™ 样本中的胶原和异物反应较少，有助于患者的舒适度。
就安全性而言，本研究未显示任何单一补片具有优势。然而，舒适度系数不同，新开发的 Physiomesh™ 最低。
