Massalou D, Masson C, Foti P, Afquir S, Baqué P, Berdah S-V, Bège T
Emergency Surgery Unit, Universitary Hospital of Nice, Hôpital Pasteur 2, Nice Sophia-Antipolis University, France; Biomechanical Applied Laboratory, UMRT24, IFSTTAR, Aix-Marseille University, France.
Biomechanical Applied Laboratory, UMRT24, IFSTTAR, Aix-Marseille University, France.
J Biomech. 2016 Dec 8;49(16):3861-3867. doi: 10.1016/j.jbiomech.2016.10.023. Epub 2016 Oct 20.
The aim of this study was to determine the mechanical response of colonic specimens retrieved from the entire human colon and placed under dynamic solicitation until the tissue ruptured.
Specimens were taken from 20 refrigerated cadavers from different locations of the colonic frame (ascending, transverse, descending and sigmoid colon) in two different directions (longitudinal and circumferential), with or without muscle strips (taenia coli). A total of 120 specimens were subjected to tensile tests, after preconditioning, at the speed of 1m/s.
High-speed video analysis showed a bilayer injury process with an initial rupture of the serosa / external muscular layer followed by a second rupture of the inner layer consisting of the internal muscle / submucosa / mucosa. The mechanical response was biphasic, with a first point of initial damage followed by a complete rupture. The levels of stress and strain at the failure site were statistically greater in terms of circumferential stress (respectively 69±22% and 1.02±0.50MPa) than for longitudinal stress (respectively 55±32% and 0.70±0.34MPa). The difference between longitudinal and circumferential stress was not statistically significant (3.17±2.05MPa for longitudinal stress and 3.15±1.73MPa for circumferential stress). The location on colic frame significantly modified the mechanical response both longitudinally and circumferentially, whereas longitudinal taenia coli showed no mechanical influence.
The mechanical response of the colon specimen under dynamic uniaxial solicitation showed a bilayer and biphasic injury process depending on the direction of solicitation and colic localization. Furthermore these results could be integrated into a numeric model reproducing abdominal trauma to better understand and prevent intestinal injuries.
本研究的目的是确定从整个人类结肠获取的结肠标本在动态拉伸直至组织破裂时的力学响应。
从20具冷藏尸体的结肠框架不同部位(升结肠、横结肠、降结肠和乙状结肠),沿两个不同方向(纵向和周向),带或不带肌条(结肠带)获取标本。总共120个标本在预处理后以1m/s的速度进行拉伸试验。
高速视频分析显示了一个双层损伤过程,先是浆膜/外层肌肉层初始破裂,随后是由内层肌肉/黏膜下层/黏膜组成的第二层破裂。力学响应是双相的,先是出现初始损伤点,随后是完全破裂。在失效部位,周向应力(分别为69±22%和1.02±0.50MPa)方面的应力和应变水平在统计学上高于纵向应力(分别为55±32%和0.70±0.34MPa)。纵向和周向应力之间的差异无统计学意义(纵向应力为3.17±2.05MPa,周向应力为3.15±1.73MPa)。结肠框架上的位置在纵向和周向上均显著改变了力学响应,而纵向结肠带未显示出力学影响。
结肠标本在动态单轴拉伸下的力学响应显示出一个双层双相损伤过程,这取决于拉伸方向和结肠定位。此外,这些结果可整合到一个再现腹部创伤的数值模型中,以更好地理解和预防肠道损伤。