Lambertz Andreas, Vogels Ruben R M, Binnebösel Marcel, Schöb Dominik S, Kossel Klas, Klinge Uwe, Neumann Ulf P, Klink Christian D
Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany.
Department of General Surgery, Maastricht University Medical Centre, 6211 LK, Maastricht, The, Netherlands.
J Biomed Mater Res A. 2015 Aug;103(8):2654-60. doi: 10.1002/jbm.a.35411. Epub 2015 Feb 9.
In hernia surgery, meshes with small pores tend to be filled by fibrous tissue, which reduces their stretchability and causes patient complaints. Because of the inelasticity of current meshes, mechanical strain might cause pores to collapse even in large-pore mesh constructions. In this study, a mesh with elastic thermoplastic polyurethane (TPU) filaments was constructed to prevent pore size changes even under mechanical strain, and its biocompatibility in comparison with polyvinylidene fluoride (PVDF) was evaluated. A mesh was constructed using PVDF with elastic TPU filaments and mechanically tested. After midline laparotomy in 20 rabbits, we placed a 15 cm × 3 cm mesh as inlay in the defect. Animals were randomized to either the TPU or PVDF group. After 7 or 21 days, mesh expansion was measured under pneumoperitoneum, and abdominal walls were explanted for immunohistochemical investigations. In vitro, TPU meshes showed a slight reduction in effective porosity from 46% at tension-free conditions to 26% under longitudinal and to 34% under transverse strain. The nonelastic PVDF meshes showed a marked reduction in effective porosity from 70% to 7% and 52%, respectively. The TPU mesh had a breaking elongation of 101% and a tensile strength of 35 N/cm. In vivo, both meshes achieved healing of the incision without hernial defect. The TPU mesh maintained its elasticity under pneumoperitoneum. The amount of CD68-positive, Ki67-positive, and apoptotic cells was significantly lower in the TPU group after 7 and 21 days. The newly developed TPU mesh shows elasticity, structural stability, and preserved effective porosity under mechanical strain. Immunohistochemistry indicates superior biocompatibility of TPU mesh compared with PVDF after 7 and 21 days.
在疝气手术中，小孔径的补片往往会被纤维组织填充，这会降低其拉伸性并引发患者的不适。由于现有补片缺乏弹性，即使是大孔径的补片结构，机械应变也可能导致孔隙塌陷。在本研究中，构建了一种带有弹性热塑性聚氨酯（TPU）细丝的补片，以防止即使在机械应变下孔径也发生变化，并评估了其与聚偏二氟乙烯（PVDF）相比的生物相容性。使用带有弹性TPU细丝的PVDF构建补片并进行力学测试。在20只兔子进行中线剖腹手术后，我们在缺损处植入一块15 cm×3 cm的补片作为镶嵌物。将动物随机分为TPU组或PVDF组。7天或21天后，在气腹状态下测量补片的扩张情况，并取出腹壁进行免疫组织化学研究。在体外，TPU补片的有效孔隙率从无张力条件下的46%略有降低，纵向应变下降至26%，横向应变下降至34%。无弹性的PVDF补片的有效孔隙率分别从70%显著降低至7%和52%。TPU补片的断裂伸长率为101%，拉伸强度为35 N/cm。在体内，两种补片都实现了切口愈合且无疝缺损。TPU补片在气腹状态下保持其弹性。7天和21天后，TPU组中CD68阳性、Ki67阳性和凋亡细胞的数量显著更低。新开发的TPU补片在机械应变下表现出弹性、结构稳定性和保留的有效孔隙率。免疫组织化学表明，7天和21天后，TPU补片与PVDF相比具有更好的生物相容性。
