Zimkowski Michael M, Rentschler Mark E, Schoen Jonathan A, Mandava Nageswara, Shandas Robin
Department of Bioengineering, University of Colorado Denver & Anschutz Medical Campus, Denver, Colorado.
J Biomed Mater Res B Appl Biomater. 2014 Jul;102(5):1093-100. doi: 10.1002/jbm.b.33091. Epub 2013 Dec 10.
Approximately 400,000 ventral hernia repair surgeries are performed each year in the United States. Many of these procedures are performed using laparoscopic minimally invasive techniques and employ the use of surgical mesh. The use of surgical mesh has been shown to reduce recurrence rates compared to standard suture repairs. The placement of surgical mesh in a ventral hernia repair procedure can be challenging, and may even complicate the procedure. Others have attempted to provide commercial solutions to the problems of mesh placement, but these have not been well accepted by the clinical community. In this article, two versions of shape memory polymer (SMP)-modified surgical mesh, and unmodified surgical mesh, were compared by performing laparoscopic manipulation in an acute porcine model. Also, SMP-integrated polyester surgical meshes were implanted in four rats for 30-33 days to evaluate chronic biocompatibility and capacity for tissue integration. Porcine results show that the modified mesh provides a controlled, temperature-activated, automated deployment when compared to an unmodified mesh. In rats, results indicate that implanted SMP-modified meshes exhibit exceptional biocompatibility and excellent integration with surrounding tissue with no noticeable differences from the unmodified counterpart. This article provides further evidence that an SMP-modified surgical mesh promises reduction in surgical placement time and that such a mesh is not substantially different from unmodified meshes in chronic biocompatibility.
在美国,每年大约进行40万例腹疝修补手术。这些手术中的许多都是采用腹腔镜微创技术,并使用外科补片。与标准缝线修补相比,使用外科补片已被证明可降低复发率。在腹疝修补手术中放置外科补片可能具有挑战性,甚至可能使手术复杂化。其他人曾试图为补片放置问题提供商业解决方案,但这些方案并未被临床界广泛接受。在本文中,通过在急性猪模型中进行腹腔镜操作,比较了两种形状记忆聚合物(SMP)改性的外科补片和未改性的外科补片。此外,将集成SMP的聚酯外科补片植入四只大鼠体内30 - 33天,以评估其慢性生物相容性和组织整合能力。猪模型的结果表明,与未改性的补片相比,改性补片可实现可控的、温度激活的自动展开。在大鼠实验中,结果表明植入的SMP改性补片具有出色的生物相容性,与周围组织的整合良好,与未改性的补片相比没有明显差异。本文进一步证明,SMP改性的外科补片有望缩短手术放置时间,并且这种补片在慢性生物相容性方面与未改性补片没有实质性差异。