Hernani Bruno De Lucia, Barros Paulo Henrique Fogaça de, Tastaldi Luciano, Ladeira Luiza Nascimento, Roll Sergio, Ferreira Fabio Gonçalves, Garcia Diego Paim Carvalho
Fellow Master degree, Postgraduate Program in Surgery Research, Santa Casa de São Paulo, School of Medical Sciences, and Hospital Alemão Oswaldo Cruz (HAOC), Sao Paulo-SP, Brazil. Acquisition of data, technical procedures, statistical analysis, manuscript preparation and writing.
MSc, HAOC, Sao Paulo-SP, Brazil. Technical procedures, manuscript preparation.
Acta Cir Bras. 2020 Nov 13;35(10):e202001001. doi: 10.1590/s0102-865020200100000001. eCollection 2020.
Incisional hernia (IH) is a frequent complication of median laparotomy. The use of prophylactic mesh to reduce IH incidence has gained increasing attention. We hypothesized that in an animal model, linea alba prophylactic reinforcement with a three-dimensional T-shaped polypropylene mesh results in greater abdominal wall resistance.
Study was performed in 27 rabbits. After abdominal midline incision, animals were divided into three groups according to the laparotomy closure method used: (1)3D T-shaped coated mesh; (2)3D T-shaped uncoated mesh; and (3) closure without mesh. After 4 months, each animal's abdominal wall was resected and tensiometric tests were applied. Results included IH occurrence, adhesions to the mesh, and wound complications.
There was no significant difference between the groups in maximum tensile strength (p=0.250) or abdominal wall elongation under maximum stress (p=0.839). One rabbit from the control group developed IH (p=1.00). Small intestine and colon adhesions occurred only in the uncoated mesh group (p<0.001) and the degree of adhesions was higher in this group compared to the coated mesh group (p<0.05).
Use of the current 3D T-shaped prophylactic mesh model did not result in a significant difference in tensiometric measurements when compared with simple abdominal wall closure in rabbits.
切口疝（IH）是正中剖腹手术常见的并发症。使用预防性补片以降低IH发生率已受到越来越多的关注。我们假设，在动物模型中，用三维T形聚丙烯补片对白线进行预防性加固可增强腹壁抗力。
对27只兔子进行研究。腹部正中切口后，根据剖腹手术闭合方法将动物分为三组：（1）三维T形涂层补片；（2）三维T形未涂层补片；（3）不使用补片闭合。4个月后，切除每只动物的腹壁并进行张力测试。结果包括IH的发生、与补片的粘连及伤口并发症。
各组间最大抗张强度（p = 0.250）或最大应力下腹壁伸长率（p = 0.839）无显著差异。对照组有1只兔子发生IH（p = 1.00）。小肠和结肠粘连仅发生在未涂层补片组（p < 0.001），且该组粘连程度高于涂层补片组（p < 0.05）。
与兔子单纯腹壁闭合相比，使用当前的三维T形预防性补片模型在张力测量方面无显著差异。
