Gruber-Blum S, Riepl N, Brand J, Keibl C, Redl H, Fortelny R H, Petter-Puchner A H
Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse 13, Austrian Cluster for Tissue Regeneration, 1200, Vienna, Austria.
Hernia. 2014 Oct;18(5):761-9. doi: 10.1007/s10029-014-1258-0. Epub 2014 May 6.
Atraumatic fixation is a key element of modern hernia repair. Two different concepts of self-adhering meshes were directly compared in this study. Adhesix(®) (AH) is coated with polyethylene glycol (PEG) and polyvinylpyrrolidone (PVP), whereas Parietene Progrip(®) (PP) relies on the mechanical principle of micro grips made of polylactic acid (PLA). These meshes are the main competitors in the field.
AH and PP were tested in Sprague-Dawley rats at 14 and 90 days. Four groups were operated (n = 8 animals per group). Two meshes were implanted per animal in an operation model of onlay hernia repair. Dislocation, tissue integration and foreign-body reaction were evaluated.
AH dislocated significantly more frequently (every second mesh) at both time points of observation than PP. Tissue integration was good with PP and could not be reliably assessed in AH due to frequent dislocation. Histologic examination revealed only a mild foreign body reaction in all groups.
In our hands, PP (mechanical grip fixation) was superior to hydrogel fixation with PEG and PVP in AH in an onlay model. The reason for dislocation of AH requires further clarification as well as the impact of long-term degradation of the PLA grips.
无创伤固定是现代疝修补术的关键要素。本研究直接比较了两种不同的自粘补片概念。Adhesix（®）（AH）涂有聚乙二醇（PEG）和聚乙烯吡咯烷酮（PVP），而Parietene Progrip（®）（PP）依靠由聚乳酸（PLA）制成的微夹的机械原理。这些补片是该领域的主要竞争对手。
在14天和90天时在Sprague-Dawley大鼠中对AH和PP进行测试。进行了四组手术（每组n = 8只动物）。在每只动物的覆盖式疝修补手术模型中植入两片补片。评估脱位、组织整合和异物反应。
在两个观察时间点，AH脱位的频率均明显高于PP（每两片补片中就有一片）。PP的组织整合良好，由于频繁脱位，AH的组织整合无法可靠评估。组织学检查显示所有组仅存在轻度异物反应。
在我们的研究中，在覆盖式模型中，PP（机械夹固定）优于AH中使用PEG和PVP的水凝胶固定。AH脱位的原因以及PLA夹长期降解的影响需要进一步阐明。
