Burcharth J, Pommergaard H-C, Klein M, Rosenberg J
Department of Surgery D, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Eur Surg Res. 2013;51(1-2):33-40. doi: 10.1159/000353970. Epub 2013 Aug 16.
Incisional hernia (IH) is a well-known complication after abdominal surgical procedures. The exact etiology of IH is still unknown even though many risk factors have been suggested. The aim of this study was to create an animal model of a weakly healed abdominal fascia that could be used to evaluate the actively healing fascia. Such an animal model may promote future research in the prevention of IH.
86 male Sprague-Dawley rats were used to establish a model involving six experiments (experiments A-F). Mechanical testing of the breaking strength of the healed fascia was performed by testing tissue strips from the healed fascia versus the unincised control fascia 7 and 28 days postoperatively.
During the six experiments a healing model was created that produced significantly weaker coherent fascia when compared with the control tissue measured in terms of mechanical breaking strength. This new animal model employed myofascial closing after a full thickness abdominal incision using a running suture with fast-absorbable suture material. This technique produced a weak myofascial layer compared with the control tissue measured in terms of breaking strength after both 7 and 28 days.
It was possible to create a healed but weak abdominal fascia in rats with a minimum of defects after incision using a running suture technique in the fascia. In contrast to other models, regular tissue defects were absent, and the model can therefore be used to evaluate the changes, both histological and mechanical, in the actively healing fascia, which may lead to incisional herniation. Furthermore, the model may also be used to study interventions performed to promote healing. This contrasts with existing models with regular fascia defects, which are not well suited for this purpose.
切口疝(IH)是腹部外科手术后一种众所周知的并发症。尽管已经提出了许多危险因素,但IH的确切病因仍然未知。本研究的目的是创建一个腹部筋膜愈合薄弱的动物模型,可用于评估正在积极愈合的筋膜。这样的动物模型可能会促进未来预防IH的研究。
86只雄性Sprague-Dawley大鼠用于建立一个包含六个实验(实验A-F)的模型。在术后7天和28天,通过测试愈合筋膜与未切开的对照筋膜的组织条来对愈合筋膜的断裂强度进行力学测试。
在这六个实验中,创建了一个愈合模型,与对照组织相比,该模型产生的连贯筋膜在力学断裂强度方面明显更弱。这个新的动物模型在全层腹部切口后采用连续缝合快速吸收缝合材料进行肌筋膜闭合。与对照组织相比,在7天和28天后,该技术产生的肌筋膜层在断裂强度方面较弱。
使用筋膜连续缝合技术,在大鼠身上切开后以最少的缺损创建一个愈合但薄弱的腹部筋膜是可能的。与其他模型不同,该模型没有常规的组织缺损,因此可用于评估正在积极愈合的筋膜在组织学和力学方面的变化,这些变化可能导致切口疝。此外,该模型还可用于研究促进愈合的干预措施。这与现有的具有常规筋膜缺损的模型形成对比,后者不太适合此目的。