Barreiro Guilherme, de Lima Vinícius S, Cavazzola Leandro T
Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Hospital Conceição, Porto Alegre, Brazil.
BMC Surg. 2019 Jun 26;19(1):68. doi: 10.1186/s12893-019-0523-7.
Clarifying the biomechanics of abdominal skin could lead to different uses for this tissue such as the ventral repair of hernias in patients with excess skin and incisional hernias. The objective of this study was to compare the maximum tensile strength of abdominal skin to commercial meshes and to verify whether or not it varies between aesthetic patients and massive weight-loss patients.
Experimental cross-sectional study. Skin samples sized 32 × 20 mm were taken from 15 abdominoplasties and 10 panniculectomies. The skin specimens were analyzed in vertical and horizontal tensile strength tests. Results were compared between the two groups including their traction directions. Commercial meshes were also tested. The results were analyzed using the Generalized Estimating Equation.
The maximum tensile strength supported vertically by abdominal dermis was 403.5 ± 27.4 N in the abdominoplasty group and 425.9 ± 33.9 N in the panniculectomy group. Horizontally, the values were 596.5 ± 32.2 N and 612.5 ± 43.9 N respectively. The strengths between traction directions were significantly different (p < 0.001). There were no differences between the groups with regard to the maximum tensile strength (p = 0.472). Tested commercial meshes had the following values: polypropylene 104.6 N, low-weight polypropylene 54.4 N, polytetrafluorethylene (PTFE) 82.2 N, and hydrated porcine small-intestinal submucosa 60.0 N.
In our study, the tensile strength of the tested human abdominal dermis samples, both aesthetic and post-bariatric, was superior to the commercial meshes. Therefore, in selected cases, abdominal dermis could be an alternative tool in abdominal reconstruction during panniculectomies with concomitant hernia repair.
阐明腹部皮肤的生物力学特性可能会使该组织有不同的用途，例如用于皮肤过多患者的腹疝修补和切口疝修补。本研究的目的是比较腹部皮肤与商用补片的最大拉伸强度，并验证其在美容手术患者和大量减重患者之间是否存在差异。
实验性横断面研究。从15例腹壁成形术和10例腹壁皮肤切除术患者中获取尺寸为32×20mm的皮肤样本。对皮肤标本进行垂直和水平拉伸强度测试。比较两组之间的结果，包括其牵引方向。还对商用补片进行了测试。使用广义估计方程对结果进行分析。
腹壁成形术组腹部真皮垂直方向支持的最大拉伸强度为403.5±27.4N，腹壁皮肤切除术组为425.9±33.9N。水平方向上，数值分别为596.5±32.2N和612.5±43.9N。牵引方向之间的强度差异显著（p<0.001）。两组之间在最大拉伸强度方面无差异（p=0.472）。测试的商用补片具有以下数值：聚丙烯104.6N，低重量聚丙烯54.4N，聚四氟乙烯（PTFE）82.2N，以及水合猪小肠黏膜下层60.0N。
在我们的研究中，经测试的美容手术患者和减重术后患者的人体腹部真皮样本的拉伸强度优于商用补片。因此，在某些选定的病例中，腹部真皮可作为腹壁皮肤切除术伴疝修补术中腹部重建的替代工具。
