Kaufmann Ruth, Jairam An P, Mulder Irene M, Wu Zhouqiao, Verhelst Joost, Vennix Sandra, Giesen Louis J X, Clahsen-van Groningen Marian C, Jeekel Johannes, Lange Johan F
1 Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
2 Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Surg Innov. 2019 Jun;26(3):302-311. doi: 10.1177/1553350619833291. Epub 2019 Mar 5.
In laparoscopic incisional hernia repair, direct contact between the prosthesis and abdominal viscera is inevitable and may lead to adhesions. Despite the large variety of mesh prosthesis, little is known about their in vivo behavior. Biological meshes are considered to have many advantages, but due to their price they are rarely used. A rat model was used to assess biological and conventional synthetic meshes on their in vivo characteristics.
One-hundred twenty male Wistar rats were randomized into five groups of 24 rats. A mesh was implanted intraperitoneally and fixated with nonresorbable sutures. The following five meshes were implanted: Parietene (polypropylene), Permacol (cross-linked porcine acellular dermal matrix), Strattice (non-cross-linked porcine acellular dermal matrix), XCM Biologic (non-cross-linked porcine acellular dermal matrix), and Omyra Mesh (condensed polytetrafluoroethylene). The rats were sacrificed after 30, 90, or 180 days. Incorporation, shrinkage, adhesions, abscess formation, and histology were assessed for all meshes.
All animals thrived postoperatively. After 180 days, Permacol, Parietene, and Omyra Mesh had a significantly better incorporation than Strattice ( P = .001, P = .019, and P = .037 respectively). After 180 days, Strattice had significantly fewer adhesions on the surface of the mesh than Parietene ( P < .001), Omyra Mesh ( P = .011), and Permacol ( P = .027). After 30 days, Permacol had significantly stronger adhesions than Strattice ( P = .030). However, this difference was not significant anymore after 180 days. After 180 days, there was significantly less shrinkage in Permacol than in Strattice ( P = .001) and Omyra Mesh ( P = .050).
Based on incorporation, adhesions, mesh shrinkage, and histologic parameters, Strattice performed best in this experimental rat model.
在腹腔镜切口疝修补术中，假体与腹腔内脏器直接接触不可避免，可能导致粘连。尽管有各种各样的网状假体，但对其体内行为了解甚少。生物网片被认为有许多优点，但由于价格原因很少使用。本研究使用大鼠模型评估生物网片和传统合成网片的体内特性。
120只雄性Wistar大鼠随机分为5组，每组24只。将网片植入腹腔并用不可吸收缝线固定。植入以下五种网片：Parietene（聚丙烯）、Permacol（交联猪脱细胞真皮基质）、Strattice（非交联猪脱细胞真皮基质）、XCM Biologic（非交联猪脱细胞真皮基质）和Omyra Mesh（浓缩聚四氟乙烯）。在30、90或180天后处死大鼠。评估所有网片的植入情况、收缩情况、粘连情况、脓肿形成情况和组织学情况。
所有动物术后均存活良好。180天后，Permacol、Parietene和Omyra Mesh的植入情况明显优于Strattice（分别为P = 0.001、P = 0.019和P = 0.037）。180天后，Strattice网片表面的粘连明显少于Parietene（P < 0.001）、Omyra Mesh（P = 0.011）和Permacol（P = 0.027）。30天后，Permacol的粘连明显比Strattice更强（P = 0.030）。然而，180天后这种差异不再显著。180天后，Permacol的收缩明显小于Strattice（P = 0.001）和Omyra Mesh（P = 0.050）。
基于植入情况、粘连情况、网片收缩情况和组织学参数，Strattice在该实验大鼠模型中表现最佳。
