Lee Bee Meng, Moore Patrick, Grossberg Peter, Clough Anthony
Medical Officer, Department of General Surgery Boxhill Hospital, Eastern Health Melbourne, Victoria, Australia.
Consultant Surgeon, Department of General Surgery Boxhill Hospital, Eastern Health Melbourne, Victoria, Australia.
Surg Technol Int. 2013 Sep;23:117-21.
The repair of complex abdominal wall defects in contaminated fields often presents a dilemma for general surgeons. Synthetic mesh, although strong, may lead to chronic infection or even visceral erosion. Leaving the abdomen open presents challenges for ward management and delays definitive care, as well as allowing the musculature to retract over time. Numerous biological mesh alternatives have arisen over the previous decade, which may make primary closure in this setting a practical alternative, although durability may prove the downside. Here we present our local experience with PermacolTM mesh (Porcine Acellular Dermal Matrix - PADM; Covidien, Mansfield, MA) in four challenging cases and discuss the role this relatively new mesh may have for these and other applications.
在污染区域修复复杂的腹壁缺损，对普通外科医生来说常常是个难题。合成补片虽然坚固，但可能导致慢性感染甚至脏器侵蚀。让腹部敞开对病房管理提出了挑战，延迟了确定性治疗，还会使肌肉组织随时间回缩。在过去十年中出现了许多生物补片替代品，这可能使在此种情况下进行一期缝合成为一种可行的选择，尽管其耐用性可能是个缺点。在此，我们介绍我们在4例具有挑战性的病例中使用PermacolTM补片（猪脱细胞真皮基质 - PADM；柯惠医疗，马萨诸塞州曼斯菲尔德）的本地经验，并讨论这种相对较新的补片在这些及其他应用中可能发挥的作用。
