Smith S, Gantt N, Rowe M I, Lloyd D A
Department of Pediatric Surgery, University of Pittsburgh School of Medicine, PA 15213-2583.
J Pediatr Surg. 1989 Jun;24(6):519-21. doi: 10.1016/s0022-3468(89)80496-8.
Occasionally, it is necessary to use prosthetic material to close large abdominal wall defects in infected, potentially infected, or open wounds. We compared the effectiveness of Gore-Tex (PTFE, W.L. Gore & Associates, Flagstaff, AZ) and dura for closing large, full thickness abdominal wall defects in terms of resistance to infection, patch separation, and intraperitoneal adhesion formation. Ninety guinea pigs had full thickness, 2 cm2, abdominal defects patched with either PTFE or dura. The skin was (A) left open (B) closed over the patch under aseptic conditions, or (C) closed after wound contamination with 10(5) CFU of staphylococcus aureus. Wounds were examined daily and the wound and peritoneal cavity examined at necropsy (day 45). Patch separation, patch retention, and adhesions were similar in both open (A), and clean closed (B) wounds patched with PTFE or dura. In the infected closed wounds (C) of the PTFE animals, the incision remained intact significantly longer, the time of patch separation and overall patch retention were significantly increased, and bowel adhesions were significantly reduced compared to dura animals.
偶尔，有必要使用假体材料来闭合感染、潜在感染或开放伤口中的大腹壁缺损。我们比较了戈尔泰克斯（聚四氟乙烯，W.L.戈尔联合公司，弗拉格斯塔夫，亚利桑那州）和硬脑膜在闭合大的全层腹壁缺损方面的有效性，包括抗感染能力、补片分离情况以及腹腔内粘连形成情况。九十只豚鼠有面积为2平方厘米的全层腹部缺损，用聚四氟乙烯或硬脑膜进行修补。皮肤的处理方式有：(A) 敞开；(B) 在无菌条件下将皮肤缝合覆盖在补片上；或 (C) 用10⁵CFU金黄色葡萄球菌污染伤口后缝合。每天检查伤口，并在尸检时（第45天）检查伤口和腹腔。用聚四氟乙烯或硬脑膜修补的敞开伤口（A）和清洁缝合伤口（B）中，补片分离、补片留存和粘连情况相似。在聚四氟乙烯组动物的感染缝合伤口（C）中，与硬脑膜组动物相比，切口保持完整的时间显著更长，补片分离时间和补片总体留存时间显著增加，肠粘连显著减少。
