Grudziadz, Torun, and Bydgoszcz, Poland From the Department of Vascular Surgery, Regional Specialist Hospital; the Department of Polymers Chemistry and Photochemistry, Faculty of Chemistry, and Departments of Pathomorphology and Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University; and the Eskulap Surgery Center.
Plast Reconstr Surg. 2013 May;131(5):731e-740e. doi: 10.1097/PRS.0b013e3182865d2c.
Intraperitoneal placement of polypropylene mesh leads to extensive visceral adhesions and is contraindicated. Different coatings are used to improve polypropylene mesh properties. Collagen is a protein with unique biocompatibility and cell ingrowth enhancement potential. A novel acetic acid extracted collagen coating was developed to allow placement of polypropylene mesh in direct contact with viscera. The authors' aim was to evaluate the long-term influence of acetic acid extracted collagen coating on surgical aspects and biomechanical properties of polypropylene mesh implanted in direct contact with viscera, including complications, adhesions with viscera, strength of incorporation, and microscopic inflammatory reaction.
Forty adult Wistar rats were divided into two groups: experimental (polypropylene mesh/acetic acid extracted collagen coating) and control (polypropylene mesh only). Astandardized procedure of mesh implantation was performed. Animals were killed 3 months after surgery and analyzed for complications, mesh area covered by adhesions, type of adhesions, strength of incorporation, and intensity of inflammatory response.
The mean adhesion area was lower for polypropylene mesh/acetic acid extracted collagen coating (14.5 percent versus 69.9 percent, p < 0.001). Adhesion severity was decreased in the experimental group: grades 0 and 1 were more frequent (p < 0.04 and p < 0.002, respectively) and grade 3 was less frequent (p < 0.0001). An association between adhesion area and severity was found (p < 0.0001). Complications, strength of incorporation, and intensity of inflammatory response to the mesh were similar.
Visceral adhesions to polypropylene mesh are significantly reduced because of acetic acid extracted collagen coating. The collagen coating does not increase complications or induce alterations of polypropylene mesh incorporation.
聚丙烯网片腹腔内放置会导致广泛的内脏粘连，因此被禁用。不同的涂层被用于改善聚丙烯网片的性能。胶原蛋白是一种具有独特生物相容性和细胞内生长增强潜力的蛋白质。一种新型的醋酸提取胶原蛋白涂层被开发出来，以允许聚丙烯网片直接与内脏接触放置。作者的目的是评估醋酸提取胶原蛋白涂层对直接接触内脏植入的聚丙烯网片的手术方面和生物力学性能的长期影响，包括并发症、与内脏的粘连、结合强度和微观炎症反应。
40 只成年 Wistar 大鼠分为两组：实验组（聚丙烯网片/醋酸提取胶原蛋白涂层）和对照组（仅聚丙烯网片）。采用标准的网片植入程序。动物在手术后 3 个月处死，并分析并发症、网片被粘连覆盖的面积、粘连的类型、结合强度和炎症反应的强度。
聚丙烯网片/醋酸提取胶原蛋白涂层的平均粘连面积较低（14.5%比 69.9%，p<0.001）。实验组的粘连严重程度降低：0 级和 1 级更常见（p<0.04 和 p<0.002 分别），3 级较少见（p<0.0001）。粘连面积和严重程度之间存在相关性（p<0.0001）。并发症、网片结合强度和炎症反应强度相似。
由于醋酸提取胶原蛋白涂层，聚丙烯网片与内脏的粘连显著减少。胶原蛋白涂层不会增加并发症或引起聚丙烯网片结合的改变。
