Cheng Amy W, Abbas Maher A, Tejirian Talar
Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.
Am Surg. 2014 Oct;80(10):999-1002.
The use of biologic mesh in abdominal wall operations has gained popularity despite a paucity of outcome data. Numerous biologic products are available with virtually no clinical comparison studies. A retrospective study was conducted to compare patients who underwent abdominal wall hernia repair with Permacol™ (crosslinked porcine dermis) and Strattice™ (noncrosslinked porcine dermis). Of 270 reviewed patients, 195 were implanted with Permacol™ and 75 with Strattice™. Ventral hernia repairs comprised the majority (85% for Permacol, 97% for Strattice™). Postoperative infection rate was lower in the Strattice™ group (5 vs 21%, P < 0.01). In the Permacol™ group only, the overall complication rates were significantly higher in patients with infected versus clean wounds (55 vs 35%, P < 0.05) and in obese patients (body mass index 40 kg/m(2) or greater [57 vs 34%], P < 0.01). Short-term complication and recurrence rates were higher when mesh was used as a fascial bridge: 51 versus 28 per cent for Permacol™, 58 versus 20 per cent for Strattice™. The hernia recurrence was similar in both groups. In this review of patients undergoing abdominal hernia repair with biologic mesh, Strattice™ mesh was associated with a lower short-term complication rate compared with Permacol™, but the hernia recurrence rate was similar.
尽管缺乏疗效数据，但生物补片在腹壁手术中的应用已越来越普遍。有多种生物产品可供使用，但几乎没有临床对比研究。本研究进行了一项回顾性研究，比较接受腹壁疝修补术并使用Permacol™（交联猪真皮）和Strattice™（非交联猪真皮）的患者。在270例接受评估的患者中，195例植入Permacol™，75例植入Strattice™。腹疝修补术占大多数（Permacol为85%，Strattice™为97%）。Strattice™组的术后感染率较低（5%对21%，P<0.01）。仅在Permacol™组中，感染伤口患者的总体并发症发生率显著高于清洁伤口患者（55%对35%，P<0.05），肥胖患者（体重指数40kg/m²或更高[57%对34%]，P<0.01）也是如此。当补片用作筋膜桥时，短期并发症和复发率较高：Permacol™为51%对28%，Strattice™为58%对20%。两组的疝复发率相似。在这项对使用生物补片进行腹疝修补术患者的回顾性研究中，与Permacol™相比，Strattice™补片的短期并发症发生率较低，但疝复发率相似。
