Martins e Quinino Reynaldo, Araújo-Filho Irami, Lima Francisco Piganataro, Barbosa André Luís Costa, Maia Tatiana de Carvalho, Goldenberg Alberto
Acta Cir Bras. 2013 Dec;28(12):807-14. doi: 10.1590/s0102-86502013001200001.
To evaluate of postoperative adhesion prevention and inflammatory response to polypropylene mesh, coated with reabsorbable hydrogel of polyethylene glycol (Coseal®) in contact with small bowel in an experimental model in rabbits.
Twenty female rabbits underwent laparotomy to implant two polypropylene meshes, 2 x 1 cm, in the right and left flanks. The right mesh was protected with Coseal® spray (Group 1) and the left mesh received no treatment after implantation (Group 2). Thirty days after implantation, the rabbits underwent laparoscopy for adhesion analysis; the prosthesis were removed en bloc with the adjacent tissue for microscopic analysis of inflammation. Statistical analysis used the Mann-Whitney test.
There was adhesion formation in five meshes (36%) from Group 1 and in 14 meshes (100%) from Group 2, with statistical significance (p<0.01). There were no differences in the inflammatory response, fibrosis, foreign body reaction, presence of collagen and type of inflammatory cells between the two groups.
Polypropylene mesh coated with Coseal® showed a significantly lower rate of adhesion formation when compared with uncoated meshes, without interfering with inflammatory response.
在兔实验模型中评估涂有聚乙二醇可吸收水凝胶(Coseal®)的聚丙烯网片与小肠接触时对术后粘连的预防作用及炎症反应。
20只雌性兔接受剖腹手术,在左右侧腹植入两片2×1厘米的聚丙烯网片。右侧网片用Coseal®喷雾保护(第1组),左侧网片植入后不做处理(第2组)。植入30天后,对兔进行腹腔镜检查以分析粘连情况;将假体与相邻组织整块切除,进行炎症的显微镜分析。统计分析采用曼-惠特尼检验。
第1组有5片网片(36%)形成粘连,第2组有14片网片(100%)形成粘连,差异有统计学意义(p<0.01)。两组在炎症反应、纤维化程度、异物反应、胶原蛋白的存在及炎症细胞类型方面无差异。
与未涂层的网片相比,涂有Coseal®的聚丙烯网片粘连形成率显著降低,且不影响炎症反应。