Murphy J L, Freeman J B, Dionne P G
Department of Pathology, Ottawa General Hospital, University of Ottawa, Ont.
Can J Surg. 1989 Jul;32(4):244-7.
Marlex and Gore-tex, two prosthetic materials used to close abdominal wounds, were compared with respect to strength and adhesion formation. A 2.5 X 3.5-cm full-thickness area of abdominal wall was excised in 32 CD rats. The defect was repaired using identically sized patches of Marlex or 1-mm Gore-tex, determined by alternate assignment, and sutured with continuous 4-0 Gore-tex. Adhesion formation was graded at necropsy and recorded photographically in each animal. The mean adhesion index (none = 0, maximal = 4) was 1.37 +/- 0.12 and 2.62 +/- 0.12 (mean +/- SEM) for Gore-tex and Marlex groups respectively (p less than 0.005, unpaired t-test). A template was used to fashion 2-cm coronal strips of abdominal wall for tensile-strength testing. The relative strengths were 2.67 +/- 0.14 and 3.02 +/- 0.16 kg/cm (mean +/- SEM) for the Gore-tex and Marlex groups respectively (NS). Histologically, there were more epithelioid giant cells and less collagen formation in the Gore-tex group. Abdominal wall reconstruction with Gore-tex resulted in wound strength equal to that of Marlex and fewer adhesions. Gore-tex is preferred when prosthetic material and viscera are in close proximity.
对用于闭合腹部伤口的两种假体材料——Marlex和Gore-tex,在强度和粘连形成方面进行了比较。在32只清洁级大鼠身上切除2.5×3.5平方厘米的腹壁全层区域。通过交替分配确定使用相同大小的Marlex补片或1毫米厚的Gore-tex补片修复缺损,并用4-0 Gore-tex连续缝合。在尸检时对粘连形成进行分级,并对每只动物进行拍照记录。Gore-tex组和Marlex组的平均粘连指数(无粘连=0,最大粘连=4)分别为1.37±0.12和2.62±0.12(平均值±标准误)(p<0.005,未配对t检验)。使用模板制作2厘米的腹壁冠状条带用于拉伸强度测试。Gore-tex组和Marlex组的相对强度分别为2.67±0.14和3.02±0.16千克/厘米(平均值±标准误)(无显著性差异)。组织学检查显示,Gore-tex组的上皮样巨细胞较多,胶原形成较少。用Gore-tex进行腹壁重建导致伤口强度与Marlex相当,粘连较少。当假体材料与内脏紧密相邻时,Gore-tex更受青睐。