Xu Xinsen, Zhan Ming, Li Xinxing, Chen Tao, Yang Linhua
Department of Biliary-Pancreatic Surgery, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.
Department of General Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai, China.
Front Surg. 2021 Jun 24;8:644227. doi: 10.3389/fsurg.2021.644227. eCollection 2021.
The mesh infection is mostly related to the gram-negative bacteria, such as Escherichia coli () for emergency surgery of incarcerated hernia. However, few study investigated the effects of concentration, mesh materials and antibiotic prophylaxis on mesh infection after hernioplasty. The aim of this study was to evaluate the bacterial resistance to for three different materials of mesh, and to measure the minimum concentration for mesh infection with and without antibiotic prophylaxis in a rat model. Three types of mesh (polytetrafluoroethylene, polypropylene, and biologic meshes) were used in the repair of an acute ventral hernia rat model in the setting of different concentrations of loads and antibiotics. At the 8th day after surgery, mesh samples were sent for microbiologic and histologic analyses. The positive rates of bacterial culture increased with concentration. The biologic mesh showed better bacterial resistance compared to polytetrafluoroethylene mesh and polypropylene mesh when the concentration of ranges from 10 CFU/ml to 10 CFU/ml ( = 0.002 and = 0.029, respectively). Prophylactical ceftriaxone treatment could not decrease the colonization rate of at 10 CFU/ml or 10 CFU/ml in each group ( > 0.05). The scores of neovascularization in polypropylene mesh and biologic mesh were similar, which was higher than that of polytetrafluoroethylene mesh ( < 0.05). Compared with other meshes, biologic mesh showed better tolerance to 10 CFU/ml with respect to inflammation, depth of inflammation, neovascularization, cellular repopulation and foreign body giant cells. The biologic mesh had better resistance compared to polytetrafluoroethylene mesh and polypropylene mesh when the concentration is higher than 10 CFU/ml in rats. Antibiotic prophylaxis was useful when the contamination was not particularly severe.
补片感染大多与革兰氏阴性菌有关，如在嵌顿疝急诊手术中的大肠杆菌。然而，很少有研究调查浓度、补片材料和抗生素预防对疝修补术后补片感染的影响。本研究的目的是评估三种不同材料补片对细菌的耐药性，并在大鼠模型中测量有无抗生素预防时补片感染的最低浓度。在不同浓度的负荷和抗生素环境下，使用三种类型的补片（聚四氟乙烯、聚丙烯和生物补片）修复急性腹疝大鼠模型。术后第8天，将补片样本送去进行微生物学和组织学分析。细菌培养阳性率随浓度增加而升高。当浓度范围为10CFU/ml至10CFU/ml时，生物补片比聚四氟乙烯补片和聚丙烯补片表现出更好的细菌耐药性（分别为P = 0.002和P = 0.029）。预防性头孢曲松治疗不能降低每组中10CFU/ml或10CFU/ml时的定植率（P>0.05）。聚丙烯补片和生物补片的新生血管化评分相似，均高于聚四氟乙烯补片（P<0.05）。与其他补片相比，生物补片在炎症、炎症深度、新生血管化、细胞再填充和异物巨细胞方面对10CFU/ml的耐受性更好。当大鼠体内浓度高于10CFU/ml时，生物补片比聚四氟乙烯补片和聚丙烯补片具有更好的耐药性。当污染不太严重时，抗生素预防是有用的。
