Tyrell J, Silberman H, Chandrasoma P, Niland J, Shull J
Department of Surgery, University of Southern California, School of Medicine, Los Angeles 90033.
Surg Gynecol Obstet. 1989 Mar;168(3):227-32.
Because previous studies evaluating prosthetic mesh have yielded conflicting results, we compared two permanent (polypropylene and polytetrafluoroethylene) and two absorbable (polyglactin and polyglycolic acid) meshes with respect to histologic appearance, development of adhesions, tensile strength and occurrence of hernias in rabbits in which defects of the abdominal wall measuring 2 by 3 centimeters were repaired with one of the meshes. Twenty experiments were performed with each material, and observations were made at two, five, seven and ten weeks. The inflammatory response was minimal with all products. Adhesions were more marked with polypropylene (Marlex) than with polytetrafluoroethylene (Gore-tex); there was no difference between the absorbable meshes. In vitro tensile strength measurements at ten weeks indicated that Marlex was superior to the other materials, and between the absorbable products, polyglactin (Vicryl) was superior to polyglycolic acid (Dexon). No hernias were observed with the nonabsorbable meshes, but all of the rabbits repaired with absorbable meshes had ventral hernias by the tenth week. Thus, absorbable meshes are not indicated when prolonged tensile strength is required, but they may be useful for other purposes, including the temporary repair of fascial defects, since evisceration was not observed.
由于先前评估人工合成补片的研究结果相互矛盾，我们比较了两种永久性（聚丙烯和聚四氟乙烯）和两种可吸收性（聚乙交酯丙交酯和聚乙醇酸）补片，观察其组织学外观、粘连形成情况、拉伸强度以及兔腹壁疝的发生情况。兔腹壁有2×3厘米的缺损，分别用其中一种补片进行修复。每种材料进行20次实验，在第2、5、7和10周进行观察。所有产品的炎症反应均轻微。聚丙烯（Marlex）补片的粘连比聚四氟乙烯（Gore-tex）补片更明显；可吸收性补片之间无差异。第10周的体外拉伸强度测量表明，Marlex补片优于其他材料，在可吸收性产品中，聚乙交酯丙交酯（Vicryl）优于聚乙醇酸（Dexon）。不可吸收性补片未观察到疝形成，但到第10周时，所有用可吸收性补片修复的兔均出现了腹疝。因此，当需要长期拉伸强度时，不建议使用可吸收性补片，但它们可能对其他目的有用，包括暂时修复筋膜缺损，因为未观察到脏器脱出。
