Ulrich Daniela, Le Teuff Isabelle, Huberlant Stephanie, Carteron Patrick, Letouzey Vincent, de Tayrac Renaud
Medical University Nimes, 4 Rue du Professeur Robert Debré, Nîmes, France.
Medical University Graz, Auenbruggerplatz 14, Graz, Austria.
PLoS One. 2017 Jun 9;12(6):e0179246. doi: 10.1371/journal.pone.0179246. eCollection 2017.
Synthetic mesh surgery for both abdominal and urogenital hernia repair is often unsatisfactory in the long-term due to postoperative complications. We hypothesized that a semi-degradable mesh hybrid may provide more appropriate biocompatibility with comparable mechanical properties. The aim was to compare its in vivo biocompatibility with a commercial polypropylene (PP) mesh.
72 rats were randomly allocated to either our new composite mesh (monofilament PP mesh knitted with polylactic-acid-fibers (PLA)) or to a commercially available PP mesh that was used as a control. 15, 90, and 180 days after implantation into the rat abdomen mesh tissue complexes were analysed for erosion, contraction, foreign body reaction, tissue integration and biomechanical properties.
No differences were seen in regard to clinical parameters including erosion, contraction or infection rates between the two groups. Biomechanical properties including breaking load, stiffness and deformation did not show any significant differences between the different materials at any timepoint. Macrophage staining did not reveal any significant differences between the two groups or between timepoints either. In regard to collagen I there was significantly less collagen I in the PP group compared to the PP/ PLA group at day 180. Collagen III did not show any significant differences at any timepoint between the two groups.
A PP/PLA hybrid mesh, leaving a low amount of PP after PLA degradation seems to have comparable biomechanical properties like PP at 180 days due to enhanced collagen production without significant differences in erosion, contraction, herniation or infection rates.
由于术后并发症，用于腹部和泌尿生殖系统疝修补的合成网片手术长期效果往往不尽人意。我们推测，一种半可降解的复合网片可能具有更合适的生物相容性以及相当的机械性能。目的是比较其与市售聚丙烯（PP）网片的体内生物相容性。
72只大鼠被随机分为两组，一组植入我们的新型复合网片（由聚乳酸纤维（PLA）编织的单丝PP网片），另一组植入市售PP网片作为对照。在将网片植入大鼠腹部后的15天、90天和180天，对网片组织复合物进行侵蚀、收缩、异物反应、组织整合和生物力学性能分析。
两组在包括侵蚀、收缩或感染率等临床参数方面没有差异。在任何时间点，不同材料之间的生物力学性能，包括断裂负荷、刚度和变形，均未显示出任何显著差异。巨噬细胞染色在两组之间或不同时间点之间也未显示出任何显著差异。在第180天，PP组的I型胶原蛋白含量明显低于PP/PLA组。两组之间在任何时间点的III型胶原蛋白均未显示出显著差异。
PLA降解后残留少量PP的PP/PLA复合网片，在180天时似乎具有与PP相当的生物力学性能，这是由于胶原蛋白生成增加，且在侵蚀、收缩、疝形成或感染率方面没有显著差异。
