Matsui T, Kitano M, Nakamura T, Shimizu Y, Hyon S H, Ikada Y
Department of Thoracic Surgery, Tenri Hospital, Nara, Japan.
J Thorac Cardiovasc Surg. 1994 Jul;108(1):162-8.
Poly-L-lactide, a polymer of lactic acid, shows slow degradation in living tissue. Poly-L-lactide plate of high molecular weight maintains more than 90% of its initial mechanical properties for more than 3 months after implantation. Using struts made from poly-L-lactide plate, we performed chest wall reconstruction in 56 patients: for postoperative chronic sternal dehiscence in 23 and sternal elevation for pectus excavatum in 33 cases. The postoperative external appearances of the anterior chest were improved in comparison with the preoperative state in all cases. The internal features were evaluated by computed tomographic scan. Neither postoperative wound infection nor respiratory complication was observed, and no tendency for regression of the anterior chest occurred in any of the patients. In 3 of 56 cases (5.4%; one in the sternal dehiscence group and two in the pectus excavatum group), it was necessary to remove part of the strut because of overgrowth of granulation tissue around the implanted material after 4, 12, and 13 postoperative months, respectively. In the pectus excavatum group, the computed tomographic evaluations showed that poly-L-lactide strut maintained sufficient strength to support the thoracic wall 5 months after implantation. These findings suggest that the bioabsorbable poly-L-lactide strut is a promising material for surgical treatment of chest deformity.
聚-L-丙交酯是乳酸的聚合物，在活体组织中降解缓慢。高分子量的聚-L-丙交酯板在植入后3个多月能保持其初始力学性能的90%以上。我们使用聚-L-丙交酯板制成的支柱对56例患者进行了胸壁重建：23例用于术后慢性胸骨裂开，33例用于漏斗胸的胸骨抬高。所有病例术后前胸的外观与术前相比均有改善。通过计算机断层扫描评估内部特征。未观察到术后伤口感染或呼吸并发症，且所有患者均未出现前胸回缩的趋势。在56例患者中有3例（5.4%；胸骨裂开组1例，漏斗胸组2例），分别在术后4个月、12个月和13个月因植入材料周围肉芽组织过度生长而需要移除部分支柱。在漏斗胸组，计算机断层扫描评估显示聚-L-丙交酯支柱在植入后5个月仍保持足够的强度来支撑胸壁。这些发现表明，可生物吸收的聚-L-丙交酯支柱是治疗胸部畸形的一种有前景的材料。
