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六种“惰性”壁层假体的抗性与生物耐受性。实验与批判性研究(作者译)

[Resistance and biological tolerance of six "inert" parietal protheses. Experimental and critical study (author's transl)].

作者信息

Arnaud J P, Eloy R, Weill-Bousson M, Greneir J F, Adloff M

出版信息

J Chir (Paris). 1977;113(1):85-100.

PMID:849968
Abstract

Six different materials (3 mesh and 3 cloth) commonly used for the repair of abdominal wall hernias were evaluated in rats. 490 animals, distributed among four experimental groups, were implanted with one of the different prostheses through musculature and peritoneum. Serial macroscopic and bacteriological investigations were done. Using an original device, bursting strength of the wound was determined in all groups at intervals. Histological criteria were used to characterize the resistance of the wound and the tolerance of the host to foreign material. Statistical analysis of the results demonstrated that: 1) after the 15th post-operative day, the resistance of the wound was similar for each material tested; 2) during this early period mesh materials exhibited more resistance to bursting pressures than cloth materials; 3) the incorporation of mesh material was constant whereas encystment or extrusion was always observed after implantation of cloth material; 4) no infection occurred with mesh material but significant bacteria were found in 18 p. 100 of cloth material implantations; 5) the extent of the cellular reaction, the enumeration of giant, inflammatory cells and fibroblasts showed superiority of mesh material; 6) the ratio of fibroblasts/inflammatory cells reflected closely the mechanical resistance and tolerance of the foreign material.

摘要

在大鼠身上评估了常用于修复腹壁疝的六种不同材料(3种网片和3种织物)。490只动物被分为四个实验组,通过肌肉组织和腹膜植入其中一种不同的假体。进行了系列宏观和细菌学研究。使用一种原创装置,定期测定所有组伤口的破裂强度。采用组织学标准来描述伤口的抵抗力以及宿主对外来材料的耐受性。结果的统计分析表明:1)术后第15天之后,所测试的每种材料的伤口抵抗力相似;2)在此早期阶段,网片材料比织物材料对破裂压力表现出更大的抵抗力;3)网片材料的融合是持续的,而织物材料植入后总是观察到包囊形成或挤出;4)网片材料未发生感染,但在18%的织物材料植入中发现了大量细菌;5)细胞反应的程度、巨细胞、炎性细胞和成纤维细胞的计数显示网片材料具有优势;6)成纤维细胞/炎性细胞的比例密切反映了外来材料的机械抵抗力和耐受性。

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