Iakovlev Vladimir V, Guelcher Scott A, Bendavid Robert
Laboratory Medicine and Pathobiology, Division of Pathology and Keenan Research Centre of the Li Ka Shing Knowledge Institute, University of Toronto, St. Michael's Hospital, Toronto, Canada.
Department of Chemical and Biomolecular Engineering, School of Engineering, Vanderbilt University, Nashville, Tennessee.
J Biomed Mater Res B Appl Biomater. 2017 Feb;105(2):237-248. doi: 10.1002/jbm.b.33502. Epub 2015 Aug 28.
Polypropylene meshes, originally introduced for hernia repair, are presently utilized in several anatomical sites. Several million are implanted annually worldwide. Depending on the device, up to 10% will be excised to treat complications. The excised meshes can provide material to study the complications, however, they have remained underutilized over the last decades and the mechanisms of complications continue to be incompletely understood. The fundamental question as to whether polypropylene degrades in vivo is still debated. We have examined 164 excised meshes using conventional microscopy to search for features of polypropylene degradation. Four specimens were also examined by transmission electron microscopy. The degraded material, detected by its ability to absorb dyes in the degradation nanopores, formed a continuous layer at the surface of the mesh fibers. It retained birefringence, inclusions of non-degraded polypropylene, and showed ability to meld with the non-degraded fiber core when heated by the surgical cautery. Several features indicated that the degradation layer formed in vivo: inflammatory cells trapped within fissures, melting caused by cautery of excision surgery, and gradual but progressive growth of the degradation layer while in the body. Cracking of the degraded material indicated a contribution to clinically important mesh stiffening and deformation. Chemical products of degradation need to be analyzed and studied for their role in the mesh-body interactions. The described methods can also be used to study degradation of other materials. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 237-248, 2017.
聚丙烯网片最初用于疝气修补，目前在多个解剖部位都有应用。全球每年植入数百万片。根据器械不同，高达10%的网片会因治疗并发症而被切除。切除的网片可为研究并发症提供材料，然而，在过去几十年里它们一直未得到充分利用，并发症的机制仍未完全明了。关于聚丙烯在体内是否会降解这一基本问题仍存在争议。我们使用传统显微镜检查了164片切除的网片，以寻找聚丙烯降解的特征。还通过透射电子显微镜检查了四个样本。通过其在降解纳米孔中吸收染料的能力检测到的降解物质，在网片纤维表面形成了一层连续的层。它保留了双折射、未降解聚丙烯的内含物，并且在手术烧灼加热时显示出与未降解纤维核心融合的能力。几个特征表明降解层是在体内形成的：裂隙中捕获的炎性细胞、切除手术烧灼引起的熔化，以及在体内时降解层逐渐但持续的生长。降解物质的开裂表明其对临床上重要的网片硬化和变形有影响。需要分析和研究降解的化学产物在网片与身体相互作用中的作用。所描述的方法也可用于研究其他材料的降解。© 2015威利期刊公司。《生物医学材料研究杂志》B部分：应用生物材料，105B: 237 - 248, 2017。
