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新一代聚乙醇酸、氧化再生纤维素和壳聚糖基疝修补网片体内黏附特性的评估

Evaluation of In Vivo Adhesion Properties of New Generation Polyglactin, Oxidized Regenerated Cellulose and Chitosan-Based Meshes for Hernia Surgery.

作者信息

Gulmez Mehmet, Aktekin Ali, Aker Fugen, Sanko Vildan, Sezer Serdar

机构信息

Department of General Surgery, Acibadem Mehmet Ali Aydinlar University Atakent Hospital, Istanbul, TUR.

Department of General Surgery, Giresun University Faculty of Medicine, Giresun, TUR.

出版信息

Cureus. 2021 Oct 13;13(10):e18755. doi: 10.7759/cureus.18755. eCollection 2021 Oct.

Abstract

Introduction Composite meshes coated with anti-adhesive barriers have been developed by taking advantage of the robustness of polypropylene meshes for use in hernia repair. We aimed to evaluate the effects of composite meshes containing polyglactin, polycaprolactone, oxidized regenerated cellulose and chitosan on the adhesion formation. Methods Forty-two Sprague Dawley male rats were divided into six groups of seven rats according to the content of the meshes used. A defect was created on the right abdominal wall of the rats and an oval composite mesh of 2 cm in diameter was placed over the defect and fixed. The rats were sacrificed under anesthesia on the 7th postoperative day. Macroscopic and histopathological examination was performed and the incorporation of the mesh with the abdominal wall and the presence of intraabdominal adhesions were evaluated. Results When the macroscopic findings of the rats were evaluated, there was a statistically significant difference between the rat groups in terms of the distribution of peritoneal adhesion scores (p<0.05). There was no statistically significant difference between the rat groups in terms of the distribution of inflammation, fibrosis and macrophage levels (p>0.05). Conclusion It was evaluated that the development of intraabdominal adhesion and the strength of adhesion decreased when biocompatible adhesion barriers with anti-adhesive properties such as oxidized regenerated cellulose and chitosan were used in the structure of composite meshes used in hernia repair. Hemostatic and antibacterial properties of these substances are promising to create the ideal mesh.

摘要

引言 通过利用聚丙烯网片在疝修补术中的坚固性,已开发出涂有抗粘连屏障的复合网片。我们旨在评估含有聚乙交酯、聚己内酯、氧化再生纤维素和壳聚糖的复合网片对粘连形成的影响。方法 根据所用网片的成分,将42只雄性Sprague Dawley大鼠分为六组,每组7只。在大鼠的右腹壁制造一个缺损,将一个直径2 cm的椭圆形复合网片置于缺损上方并固定。术后第7天在麻醉下处死大鼠。进行宏观和组织病理学检查,并评估网片与腹壁的融合情况以及腹腔内粘连的存在情况。结果 评估大鼠的宏观表现时,各大鼠组在腹膜粘连评分分布方面存在统计学显著差异(p<0.05)。各大鼠组在炎症、纤维化和巨噬细胞水平分布方面无统计学显著差异(p>0.05)。结论 评估发现,在用于疝修补的复合网片结构中使用具有抗粘连特性的生物相容性粘连屏障(如氧化再生纤维素和壳聚糖)时,腹腔内粘连的发生和粘连强度会降低。这些物质的止血和抗菌特性有望创造出理想的网片。

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