Serigiolle Leonardo Carvalho, Barbieri Renato Lamounier, Gomes Helbert Minuncio Pereira, Rodrigues Daren Athiê Boy, Studart Sarah do Valle, Leme Pedro Luiz Squilacci
University Nove de Julho, University Nove de Julho, São Paulo, SP, Brazil.
Arq Bras Cir Dig. 2015 Jul-Sep;28(3):178-82. doi: 10.1590/S0102-67202015000300008.
Adhesions induced by biomaterials experimentally implanted in the abdominal cavity are basically studied by primary repair of different abdominal wall defects or by the correction of incisional hernias previously performed with no precise definition of the most appropriate model.
To describe the adhesions which occur after the development of incisional hernias, before the prosthesis implantation, in an experimental model to study the changes induced by different meshes.
Incisional hernias were performed in 10 rats with hernia orifices of standardized dimensions, obtained by the median incision of the abdominal wall and eversion of the defect edges. Ten days after the procedure adhesions of abdominal structures were found when hernias were repaired with different meshes.
The results showed hernia sac well defined in all rats ten days after the initial procedure. Adhesions of the greater omentum occurred in five animals of which two also showed adhesions of small bowel loops besides the omentum, and another two showed liver adhesions as well as the greater omentum, numbers with statistical significance by Student's t test (p<0.05).
Although it reproduces the real clinical situation, the choice of experimental model of incisional hernia repair previously induced implies important adhesions, with possible repercussions in the evaluation of the second operation, when different implants of synthetic materials are used.
通过对不同腹壁缺损进行一期修复或对先前已施行的切口疝进行修补来对实验性植入腹腔的生物材料所诱导的粘连进行基础研究,但对于最合适的模型尚无精确界定。
在一个实验模型中描述在假体植入前切口疝形成后所出现的粘连情况,以研究不同补片所诱导的变化。
对10只大鼠制造切口疝,通过腹壁正中切口及缺损边缘外翻获得尺寸标准化的疝孔。手术10天后,当用不同补片修补疝时发现腹部结构的粘连。
结果显示在初始手术后10天,所有大鼠的疝囊均清晰可见。5只动物出现大网膜粘连,其中2只除大网膜外还显示小肠袢粘连,另外2只除大网膜粘连外还出现肝脏粘连,经学生t检验,这些数字具有统计学意义(p<0.05)。
尽管它再现了真实的临床情况,但选择先前已诱导形成的切口疝修补实验模型意味着存在重要粘连,在使用不同合成材料植入物进行二次手术评估时可能产生影响。