Mulder Irene M, Deerenberg Eva B, Bemelman Willem A, Jeekel Johannes, Lange Johan F
Laboratory of Experimental Surgery, Department of Surgery, Erasmus University Medical Center, Room Ee-173, P.O. Box 2040, Rotterdam 3000, The Netherlands.
Laboratory of Experimental Surgery, Department of Surgery, Erasmus University Medical Center, Room Ee-173, P.O. Box 2040, Rotterdam 3000, The Netherlands.
Am J Surg. 2015 Jul;210(1):159-66. doi: 10.1016/j.amjsurg.2014.06.025. Epub 2014 Aug 7.
This experimental study investigates infectious complications and functional outcome of biological meshes in a contaminated environment.
In 90 rats peritonitis was induced, and after 24 hours, a biological mesh was implanted intraperitoneally including 2 non-crosslinked mesh groups (Strattice and Surgisis) and 2 crosslinked mesh groups (CollaMendFM and Permacol). Sacrifice was after 90 and 180 days.
More mesh infections occurred in crosslinked meshes compared with non-crosslinked meshes (70% vs 4%; P < .001). Mesh infection was the highest in crosslinked CollaMendFM (81.2%) and lowest in non-crosslinked Strattice groups (0%). Incorporation into the abdominal wall was poor in all meshes (0% to 39%). After 180 days no residue of non-crosslinked Surgisis mesh was found. After 180 days, shrinkage was .8% in crosslinked Permacol and 20% in Strattice groups. Strattice showed the least adhesion formation (median 5%).
Infection rate of biological meshes in a contaminated field was the highest in crosslinked meshes. All biological meshes showed poor incorporation, which makes long-term abdominal wall repair questionable.
本实验研究旨在调查在污染环境中生物补片的感染并发症及功能转归。
对90只大鼠诱发腹膜炎,24小时后将生物补片植入腹腔,包括2个非交联补片组(Strattice和Surgisis)和2个交联补片组(CollaMendFM和Permacol)。分别在90天和180天后处死大鼠。
与非交联补片相比,交联补片发生的补片感染更多(70%对4%;P <.001)。交联的CollaMendFM补片感染率最高(81.2%),非交联的Strattice组最低(0%)。所有补片与腹壁的融合均较差(0%至39%)。180天后未发现非交联的Surgisis补片残留。180天后,交联的Permacol组补片收缩率为0.8%,Strattice组为20%。Strattice补片形成的粘连最少(中位数为5%)。
在污染区域生物补片的感染率在交联补片中最高。所有生物补片均显示融合较差,这使得长期腹壁修复存在疑问。